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Does idiopathic congenital talipes equinovarus have an impact on attainment of developmental milestones? A multicentre international study
PURPOSE: The Ponseti method is a well-established approach to treating clubfoot. Potentially, both the underlying pathology and adherence to post-correction bracing can affect lower limb function and age of independent standing and walking. This cohort study investigates the age at which infants wit...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The British Editorial Society of Bone & Joint Surgery
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6701447/ https://www.ncbi.nlm.nih.gov/pubmed/31489040 http://dx.doi.org/10.1302/1863-2548.13.190060 |
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author | Hughes, K. Gelfer, Y. Cokljat, M. Wientroub, S. Yavor, A. Hemo, Y. Dunkley, M. Eastwood, D. M. |
author_facet | Hughes, K. Gelfer, Y. Cokljat, M. Wientroub, S. Yavor, A. Hemo, Y. Dunkley, M. Eastwood, D. M. |
author_sort | Hughes, K. |
collection | PubMed |
description | PURPOSE: The Ponseti method is a well-established approach to treating clubfoot. Potentially, both the underlying pathology and adherence to post-correction bracing can affect lower limb function and age of independent standing and walking. This cohort study investigates the age at which infants with idiopathic clubfoot treated using the Ponseti method achieved three selected developmental milestones and whether or not this correlated with treatment compliance. METHODS: A prospectively collected database from four centres was visited. Inclusion criteria were patients with idiopathic clubfoot with no comorbidities or prior treatment. Age at attainment of independent standing, walking, nocturnal continence was compared across three groups: I) congenital talipes equinovarus (CTEV) children compliant with treatment; II) CTEV children non-compliant with treatment; and III) typically-developed siblings. Minimum follow-up was five years. RESULTS: In all, 130 patients (198 feet) fitted the inclusion criteria: 43:87 (F:M). Standing was achieved by a mean 12.0 months in group I (sd 2.50); 12.0 months (sd 2.0) in II and ten months (sd 3.0) in III. Walking was achieved by a mean 15 months (sd 4.0) in group I, 14 months (sd 1.75) in II and 12 months (sd 3) in III, respectively. Both the compliant and non-compliant CTEV children were significantly slower at achieving standing and walking compared to sibling controls (p < 0.0001). There was no significant difference between age of nocturnal continence between the three groups. CONCLUSION: Infants with idiopathic clubfoot treated according to the Ponseti method achieve independent standing and walking approximately two months later than their typically-developed siblings. The delay is not related to the use of the foot abduction brace. LEVEL OF EVIDENCE: III |
format | Online Article Text |
id | pubmed-6701447 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | The British Editorial Society of Bone & Joint Surgery |
record_format | MEDLINE/PubMed |
spelling | pubmed-67014472019-09-05 Does idiopathic congenital talipes equinovarus have an impact on attainment of developmental milestones? A multicentre international study Hughes, K. Gelfer, Y. Cokljat, M. Wientroub, S. Yavor, A. Hemo, Y. Dunkley, M. Eastwood, D. M. J Child Orthop Original Clinical Article PURPOSE: The Ponseti method is a well-established approach to treating clubfoot. Potentially, both the underlying pathology and adherence to post-correction bracing can affect lower limb function and age of independent standing and walking. This cohort study investigates the age at which infants with idiopathic clubfoot treated using the Ponseti method achieved three selected developmental milestones and whether or not this correlated with treatment compliance. METHODS: A prospectively collected database from four centres was visited. Inclusion criteria were patients with idiopathic clubfoot with no comorbidities or prior treatment. Age at attainment of independent standing, walking, nocturnal continence was compared across three groups: I) congenital talipes equinovarus (CTEV) children compliant with treatment; II) CTEV children non-compliant with treatment; and III) typically-developed siblings. Minimum follow-up was five years. RESULTS: In all, 130 patients (198 feet) fitted the inclusion criteria: 43:87 (F:M). Standing was achieved by a mean 12.0 months in group I (sd 2.50); 12.0 months (sd 2.0) in II and ten months (sd 3.0) in III. Walking was achieved by a mean 15 months (sd 4.0) in group I, 14 months (sd 1.75) in II and 12 months (sd 3) in III, respectively. Both the compliant and non-compliant CTEV children were significantly slower at achieving standing and walking compared to sibling controls (p < 0.0001). There was no significant difference between age of nocturnal continence between the three groups. CONCLUSION: Infants with idiopathic clubfoot treated according to the Ponseti method achieve independent standing and walking approximately two months later than their typically-developed siblings. The delay is not related to the use of the foot abduction brace. LEVEL OF EVIDENCE: III The British Editorial Society of Bone & Joint Surgery 2019-08-01 /pmc/articles/PMC6701447/ /pubmed/31489040 http://dx.doi.org/10.1302/1863-2548.13.190060 Text en Copyright © 2019, The author(s) http://creativecommons.org/licenses/by-nc/4.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed. |
spellingShingle | Original Clinical Article Hughes, K. Gelfer, Y. Cokljat, M. Wientroub, S. Yavor, A. Hemo, Y. Dunkley, M. Eastwood, D. M. Does idiopathic congenital talipes equinovarus have an impact on attainment of developmental milestones? A multicentre international study |
title | Does idiopathic congenital talipes equinovarus have an impact on attainment of developmental milestones? A multicentre international study |
title_full | Does idiopathic congenital talipes equinovarus have an impact on attainment of developmental milestones? A multicentre international study |
title_fullStr | Does idiopathic congenital talipes equinovarus have an impact on attainment of developmental milestones? A multicentre international study |
title_full_unstemmed | Does idiopathic congenital talipes equinovarus have an impact on attainment of developmental milestones? A multicentre international study |
title_short | Does idiopathic congenital talipes equinovarus have an impact on attainment of developmental milestones? A multicentre international study |
title_sort | does idiopathic congenital talipes equinovarus have an impact on attainment of developmental milestones? a multicentre international study |
topic | Original Clinical Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6701447/ https://www.ncbi.nlm.nih.gov/pubmed/31489040 http://dx.doi.org/10.1302/1863-2548.13.190060 |
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