Title |
Mid-term results of a physiotherapist-led Ponseti service for the management of non-idiopathic and idiopathic clubfoot
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Published in |
Journal of Children's Orthopaedics, June 2015
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DOI | 10.1007/s11832-015-0658-8 |
Pubmed ID | |
Authors |
Mia Dunkley, Yael Gelfer, Debbie Jackson, Evette Parnell, Jennifer Armstong, Cristina Rafter, Deborah M. Eastwood |
Abstract |
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. 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. 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. 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. Prognostic Level III. |
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South Africa | 1 | 100% |
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Members of the public | 1 | 100% |
Mendeley readers
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Unknown | 53 | 100% |
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Student > Bachelor | 14 | 26% |
Researcher | 7 | 13% |
Student > Postgraduate | 5 | 9% |
Student > Master | 5 | 9% |
Professor | 4 | 8% |
Other | 6 | 11% |
Unknown | 12 | 23% |
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Nursing and Health Professions | 9 | 17% |
Engineering | 3 | 6% |
Sports and Recreations | 2 | 4% |
Linguistics | 1 | 2% |
Other | 2 | 4% |
Unknown | 12 | 23% |