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Mid-term results of a physiotherapist-led Ponseti service for the management of non-idiopathic and idiopathic clubfoot

BACKGROUND: The Ponseti method is the preferred treatment for idiopathic clubfoot. Although popularised by orthopaedic surgeons it has expanded to physiotherapists and other health practitioners. This study reviews the results of a physiotherapist-led Ponseti service for idiopathic and non-idiopathi...

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Autores principales: Dunkley, Mia, Gelfer, Yael, Jackson, Debbie, Parnell, Evette, Armstong, Jennifer, Rafter, Cristina, Eastwood, Deborah M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4486504/
https://www.ncbi.nlm.nih.gov/pubmed/26072327
http://dx.doi.org/10.1007/s11832-015-0658-8
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author Dunkley, Mia
Gelfer, Yael
Jackson, Debbie
Parnell, Evette
Armstong, Jennifer
Rafter, Cristina
Eastwood, Deborah M.
author_facet Dunkley, Mia
Gelfer, Yael
Jackson, Debbie
Parnell, Evette
Armstong, Jennifer
Rafter, Cristina
Eastwood, Deborah M.
author_sort Dunkley, Mia
collection PubMed
description BACKGROUND: The Ponseti method is the preferred treatment for idiopathic clubfoot. Although popularised by orthopaedic surgeons it has expanded to physiotherapists and other health practitioners. This study reviews the results of a physiotherapist-led Ponseti service for idiopathic and non-idiopathic clubfeet and compares these results with those reported by other groups. METHOD: A prospective cohort of clubfeet (2005–2012) with a minimum 2-year follow-up after correction was reviewed. Physiotherapists treated 91 children—41 patients (69 feet) had non-idiopathic deformities and 50 children (77 feet) were idiopathic. Objective outcomes were evaluated and compared to results from other groups managing similar patient cohorts. RESULTS: The mean follow-up was 4.6 years (range 2–8.3 years) for both groups. The non-idiopathic group required a median of 7 casts to correct the clubfoot deformity with an 83 % tenotomy rate compared to a median of 5 casts for the idiopathic group with a 63 % tenotomy rate. Initial correction was achieved in 96 % of non-idiopathic feet and in 100 % of idiopathic feet. Recurrence requiring additional treatment was higher in the non-idiopathic group with 40 % of patients (36 % of feet) sustaining a relapse as opposed to 8 % (6 % feet) in the idiopathic group. Surgery was required in 26 % of relapsed non-idiopathic feet and 6 % of idiopathic. CONCLUSIONS: Although Ponseti treatment was not as successful in non-idiopathic feet as in idiopathic feet, deformity correction was achieved and maintained in the mid-term for the majority of feet. These results compare favourably to other specialist orthopaedic-based services for Ponseti management of non-idiopathic clubfeet. LEVEL OF EVIDENCE: Prognostic Level III.
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spelling pubmed-44865042015-07-02 Mid-term results of a physiotherapist-led Ponseti service for the management of non-idiopathic and idiopathic clubfoot Dunkley, Mia Gelfer, Yael Jackson, Debbie Parnell, Evette Armstong, Jennifer Rafter, Cristina Eastwood, Deborah M. J Child Orthop Original Clinical Article BACKGROUND: The Ponseti method is the preferred treatment for idiopathic clubfoot. Although popularised by orthopaedic surgeons it has expanded to physiotherapists and other health practitioners. This study reviews the results of a physiotherapist-led Ponseti service for idiopathic and non-idiopathic clubfeet and compares these results with those reported by other groups. METHOD: A prospective cohort of clubfeet (2005–2012) with a minimum 2-year follow-up after correction was reviewed. Physiotherapists treated 91 children—41 patients (69 feet) had non-idiopathic deformities and 50 children (77 feet) were idiopathic. Objective outcomes were evaluated and compared to results from other groups managing similar patient cohorts. RESULTS: The mean follow-up was 4.6 years (range 2–8.3 years) for both groups. The non-idiopathic group required a median of 7 casts to correct the clubfoot deformity with an 83 % tenotomy rate compared to a median of 5 casts for the idiopathic group with a 63 % tenotomy rate. Initial correction was achieved in 96 % of non-idiopathic feet and in 100 % of idiopathic feet. Recurrence requiring additional treatment was higher in the non-idiopathic group with 40 % of patients (36 % of feet) sustaining a relapse as opposed to 8 % (6 % feet) in the idiopathic group. Surgery was required in 26 % of relapsed non-idiopathic feet and 6 % of idiopathic. CONCLUSIONS: Although Ponseti treatment was not as successful in non-idiopathic feet as in idiopathic feet, deformity correction was achieved and maintained in the mid-term for the majority of feet. These results compare favourably to other specialist orthopaedic-based services for Ponseti management of non-idiopathic clubfeet. LEVEL OF EVIDENCE: Prognostic Level III. Springer Berlin Heidelberg 2015-06-14 2015-06 /pmc/articles/PMC4486504/ /pubmed/26072327 http://dx.doi.org/10.1007/s11832-015-0658-8 Text en © The Author(s) 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Clinical Article
Dunkley, Mia
Gelfer, Yael
Jackson, Debbie
Parnell, Evette
Armstong, Jennifer
Rafter, Cristina
Eastwood, Deborah M.
Mid-term results of a physiotherapist-led Ponseti service for the management of non-idiopathic and idiopathic clubfoot
title Mid-term results of a physiotherapist-led Ponseti service for the management of non-idiopathic and idiopathic clubfoot
title_full Mid-term results of a physiotherapist-led Ponseti service for the management of non-idiopathic and idiopathic clubfoot
title_fullStr Mid-term results of a physiotherapist-led Ponseti service for the management of non-idiopathic and idiopathic clubfoot
title_full_unstemmed Mid-term results of a physiotherapist-led Ponseti service for the management of non-idiopathic and idiopathic clubfoot
title_short Mid-term results of a physiotherapist-led Ponseti service for the management of non-idiopathic and idiopathic clubfoot
title_sort mid-term results of a physiotherapist-led ponseti service for the management of non-idiopathic and idiopathic clubfoot
topic Original Clinical Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4486504/
https://www.ncbi.nlm.nih.gov/pubmed/26072327
http://dx.doi.org/10.1007/s11832-015-0658-8
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