Clubfoot and Tethered Cord Syndrome: Results of Treatment With the Ponseti Method

Jackson, Trevor; Jones, Alexander; Miller, Nancy H.; Georgopoulos, Gaia

doi:10.1097/bpo.0000000000000944

Cited by 12 publications

(19 citation statements)

References 28 publications

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“…1). 7,[16][17][18][19][20][21][22][23][24][25] The MINORS of each article was calculated which yielded scores ranging from 11/16 to 12/16 for non-comparative studies and from 18/24 to 21/24 for comparative studies. Because of the limited amount of studies reporting results on treatment of non-idiopathic clubfeet with the Ponseti method, all studies were included regardless of the MINORS.…”

Section: Resultsmentioning

confidence: 99%

Treatment of non-idiopathic clubfeet with the Ponseti method: A systematic review

Mulder

Prinsen

Campenhout

2018

Journal of Children's Orthopaedics

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PurposeAlthough non-idiopathic clubfeet were long thought to be resistant to non-surgical treatment methods, more studies documenting results on treatment of these feet with the Ponseti method are being published. The goal of this systematic review is to summarize current evidence on treatment of non-idiopathic clubfeet using the Ponseti method.MethodsPubMed and Limo were searched, reference lists of eligible studies were screened and studies that met the inclusion criteria were included. Data on average number of casts, Achilles tendon tenotomy (ATT), initial correction, recurrence, successful treatment at final follow-up and complications were pooled. The Methodological Index for Non-Randomized Studies was used to assess the methodological quality of the selected studies.ResultsIn all, 11 studies were included, yielding a total of 374 non-idiopathic and 801 idiopathic clubfeet. Non-idiopathic clubfeet required more casts (7.2 versus 5.4) and had a higher rate of ATT (89.4% versus 75.7%). Furthermore, these feet had a higher recurrence rate (43.3% versus 11.5%) and a lower rate of successful treatment at final follow-up (69.3% versus 95.0%). Complications were found in 20.3% of the non-idiopathic cohort. When comparing results between clubfeet associated with myelomeningocele and arthrogryposis, the first group presented with a lower number of casts (5.4 versus 7.2) and a higher rate of successful treatment at final follow-up (81.8% versus 58.2%).ConclusionThe Ponseti method is a valuable and non-invasive option in the primary treatment of non-idiopathic clubfeet in young children. Studies with longer follow-up are necessary to evaluate its long-term effect.Level of EvidenceLevel III – systematic review of Level-III studies.This work meets the requirements of the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses).

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Section: Resultsmentioning

confidence: 99%

Treatment of non-idiopathic clubfeet with the Ponseti method: A systematic review

Mulder

Prinsen

Campenhout

2018

Journal of Children's Orthopaedics

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“…The conventional practice has been to perform extensive soft tissue and bony surgeries to correct the deformity, which often resulted in stiff and painful feet, high relapse rates, and unsatisfactory outcomes [6][7][8][9][10][11]. Considering the poor outcomes of radical surgery and parallel with the surge of interest in conservative methods of clubfoot treatment over the past few decades, several researchers have reported on the use of the Ponseti method for these difficult feet [12][13][14][16][17][18][19][20][21][22][23][24][25][26].…”

Section: Discussionmentioning

confidence: 99%

“…Both studies were of a small series of 12-16 patients with amyoplasia or distal arthrogryposis and showed a variable success rate of 70-92% at a mean short-term follow-up of 3 years [12,13]. Subsequently, a few more articles in literature [14,[16][17][18][19][20][21][22][23][24][25][26] have reported on the successful short-term outcomes of the Ponseti method in non-idiopathic clubfeet. However, some of these articles have focused on a particular aetiology (Arthrogryposis, Myelomeningocele, etc.)…”

Section: Discussionmentioning

confidence: 99%

The Ponseti method of treatment for neuromuscular and syndromic (non-idiopathic) clubfeet: evaluation of a programme-based approach at a mean follow-up of 5.8 years

Shah

Aroojis

Mehta

2020

International Orthopaedics (SICOT)

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Purpose To analyse the results of the Ponseti method in the treatment of non-idiopathic clubfeet and compare them with idiopathic clubfeet in a programme-based setting using a standardized protocol Methods We reviewed two groups of 782 children treated prospectively in our programme-based Clubfoot Clinic: group I comprised of 89 patients (146 feet) with non-idiopathic clubfoot and group II comprised of 693 patients (1032 feet) with idiopathic clubfoot. Both groups were compared on the basis of patient demographics, number of casts, tenotomy rate, success rate, rate of recurrences, and the need for additional secondary procedures. Results Non-idiopathic clubfeet had a higher incidence of bilateral involvement (p = 0.0093) and affected both males and females equally (p = 0.002) as compared with idiopathic clubfeet. Non-idiopathic clubfeet (group I) required significantly more casts (6.75 ± 4.2) compared with idiopathic clubfeet (4.23 ± 4.14), had a higher rate of Achilles tenotomy (90.4% vs 75%, p < 0.0001), and had a lower initial correction rate compared with idiopathic clubfeet (92.5% vs 100%, p < 0.0001). There was a significant difference in the recurrence rates between the two groups, as 42.5% of non-idiopathic feet (38 patients) relapsed compared with 10.2% (71 patients) in the idiopathic group (p < 0.0001). Most recurrences in group I were amenable to re-casting, with only nine patients (14 non-idiopathic clubfeet) requiring extensive soft tissue releases. The final success rate in the non-idiopathic group at a mean follow-up of 5.8 years (2-8 years) was 87.7%. Conclusions We recommend the use of the Ponseti method as an effective treatment for non-idiopathic clubfeet associated with neuromuscular and syndromic conditions.

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“…But, Jackson et al concluded that clubfoot associated with constriction band required more casts to achieve an acceptable correction and had an increased risk of deformity recurrence compared with subjects with isolated clubfoot (15).…”

Section: Discussionmentioning

confidence: 99%

Clubfeet and Constriction Band Syndrome - Case Report

Shabani

Bytyqi

2020

Preprint

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Background: Clubfeet and constriction band syndrome is very rare nonidiopathic condition. Treatment is often difficult and the recurrence deformity rate is high. The purpose of this study was to assess the effectiveness of Ponseti method in treatment of congenital constriction band syndrome accompanied clubfoot deformity and lymphedema.Case presentation: We are presenting an interesting case of bilateral clubfeet and congenital circumferential constriction band syndrome in lower limb. Ponseti method of correcting the congenital clubfoot deformity was applied. Constriction band release is accomplished by two stage completely excising the ﬁbrous band and multiple two stage Z-plasties on the right calf.Conclusion: The results of this study indicate that the Ponseti method of gentle, systematic manipulation and weekly cast changes is effective treatment of nonidiopathic clubfoot distal to congenital amniotic constriction band.

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Clubfoot and Tethered Cord Syndrome: Results of Treatment With the Ponseti Method

Abstract: Level II-retrospective prognostic study.

Cited by 12 publications

References 28 publications

Treatment of non-idiopathic clubfeet with the Ponseti method: A systematic review

Treatment of non-idiopathic clubfeet with the Ponseti method: A systematic review

The Ponseti method of treatment for neuromuscular and syndromic (non-idiopathic) clubfeet: evaluation of a programme-based approach at a mean follow-up of 5.8 years

Clubfeet and Constriction Band Syndrome - Case Report

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