A method for the early evaluation of the Ponseti (Iowa) technique for the treatment of idiopathic clubfoot

Lehman, Wallace B.; Mohaideen, Ahamed; Madan, Sanjeev; Scher, David M.; Bosse, Harold J. P. van; Iannacone, Michelle; Bazzi, Jamal; Feldman, David S.

doi:10.1097/01202412-200303000-00011

Cited by 65 publications

(103 citation statements)

References 6 publications

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“…Colburn and Williams [6] found only three of 57 feet treated by the Ponseti method required extensive surgical correction. This pattern of good short-term results has been replicated in many recent studies [1,2,4,6,8,9,17,19,21].…”

Section: Discussionsupporting

confidence: 67%

“…However, strictly following the brace protocol seems to be the major challenge of the Ponseti method. Many authors report brace intolerance rates of 30% to 49% [1,7,11,14,21]. Our brace intolerance rate was as high as 44.3%.…”

Section: Discussionmentioning

confidence: 44%

“…For example, five of 11 brace-intolerant patients in the study of Lehman et al [21] had a good result. In another study [1], 30 brace-intolerant patients required no additional surgery.…”

Section: Discussionmentioning

confidence: 95%

“…A recent questionnaire reported that 65% of the Pediatric Orthopaedic Society of North America members used the Ponseti method [16]. However, all recently published reports describe only short-term followup of 1 to 2 years [1,2,4,6,8,9,17,19,21].…”

Section: Introductionmentioning

confidence: 99%

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Ponseti Treatment for Idiopathic Clubfoot: Minimum 5-year Followup

Bor

Coplan

Herzenberg

2009

Clinical Orthopaedics &Amp; Related Research

140

117

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Ponseti clubfoot treatment has become more popular during the last decade. We reviewed the medical records of 74 consecutive infants (117 club feet) who underwent Ponseti treatment. Minimum followup was 5 years (mean, 6.3 years; range, 5-9 years). We studied age at presentation, previous treatment, the initial severity score of the Pirani scoring system, number of casts, need for Achilles tenotomy or other surgical procedures, and brace use. We measured final ankle motion and parents' perception of outcome. Late presentation and previous nonPonseti treatment were associated with lower initial severity score, fewer casts, and less need for tenotomy.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 44%

“…For example, five of 11 brace-intolerant patients in the study of Lehman et al [21] had a good result. In another study [1], 30 brace-intolerant patients required no additional surgery.…”

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Ponseti Treatment for Idiopathic Clubfoot: Minimum 5-year Followup

Bor

Coplan

Herzenberg

2009

Clinical Orthopaedics &Amp; Related Research

140

117

View full text Add to dashboard Cite

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“…Ponseti first introduced his non-surgical method of clubfoot correction more than 50 years ago [3] and he has reported satisfactory results in 89% of treated feet [1]. Reports on failures with the Ponseti method have shown that the decisive factor that led to recurrence of the clubfoot deformity in 50% of the cases was non-compliance with the foot abduction brace protocol [2,[4][5][6][7]. Once the last cast has been removed, adherence to the brace protocol is crucial to success and the prevention of recurrence.…”

Section: Introductionmentioning

confidence: 99%

The influence of brace type on the success rate of the Ponseti treatment protocol for idiopathic clubfoot

Hemo

Segev

Yavor

et al. 2011

Journal of Children's Orthopaedics

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Purpose The success of the Ponseti method for treating idiopathic clubfoot deformity is dependent on the casting techniques and the adherence of the patient to the foot abduction brace protocol. Newly developed brace designs claim to be more comfortable, to be easier to use and to prevent dislodgement of the foot from the brace, making them more efficient and improving patient compliance. They are, however, more costly, and, therefore, accessible to fewer patients. We compared the compliance and treatment outcome using two brace designs, the traditional simple brace of pre-walking shoes attached to a Dennis Browne (DB) bar and the new sophisticated Mitchell brace. Methods We compared the functional outcome and compliance with the post-corrective bracing protocol of 38 children with idiopathic clubfoot treated in our institution using two brace designs. Twenty-one chose the DB brace and 17 chose the Mitchell brace. Results There was no difference in the compliance rate or in the final clinical and radiological outcomes of the two groups after a minimum of 2 years of follow-up. A positive correlation was found between the Pirani score at the beginning of treatment and the final functional score for both groups. Both groups were satisfied with the selected brace. Both groups were equally compliant with the brace protocol. Conclusion We conclude that new and more expensive brace designs do not necessarily provide better clinical results. Fully corrected foot and a strong family-treating team partnership are crucial to adherence with the brace protocol.

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