Early developmental milestones in patients with idiopathic clubfoot treated by Ponseti method

Pavone, Vito; Sapienza, Marco; Vescio, Andrea; Caldaci, Alessia; McCracken, Kathryn Louise; Canavese, Federico; Testa, Gianluca

doi:10.3389/fped.2022.869401

Cited by 7 publications

(12 citation statements)

References 24 publications

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“…Regardless of etiology, clubfoot has successfully been managed for several decades. Despite the method’s success, patients treated using the Ponseti technique have been shown to achieve delayed independent gait [ 19 ]. However, this may not be surprising considering the initial deformity that impedes the child’s ability to ambulate.…”

Section: Introductionmentioning

confidence: 99%

Current Clubfoot Practices: POSNA Membership Survey

et al. 2023

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Clubfoot management has advanced in the 21st century with increases in formal training, practitioner experience, and improved casting/bracing constructs. The Ponseti method is the gold standard, yet variations in application persist. This survey aims to identify current treatment practices among clubfoot practitioners within the Pediatric Orthopaedic Society of North America (POSNA). A 23-question online survey of members was conducted between June and August 2021. Eighty-nine respondents self-identified as clubfoot providers. Of these, 93.1% had an MD degree, 23.6% possessed >30 years’ experience, and the majority (65.6%) worked in a teaching hospital associated with a medical school. Most responders (92.0%) were pediatric fellowship trained. A total of 51.7% had participated in a clubfoot training course. More than half (57.5%) noted changes to clubfoot management practices throughout their training. A majority used between four and seven (88.7%) long leg casts (98.4%), changed at seven-day intervals (93.4%). Plaster (69.4%) was most commonly used. The most common bracing device was Mitchell–Ponseti (72.9%). A mean 84.8% of clubfeet required tenotomy. The most common anesthetic agent was numbing gel (43.0%). Tenotomies mostly occurred in patients aged <6 months (63.1%). Tenotomy locations were operating room (46.5%), clinic (45.4%) and procedure room (8.1%). Cast removal was primarily performed with saws (54.7%). The mean incidence of observed cast burns was 5.5%. Most providers did not use a device to prevent cast burns (76.6%). Reported cast complications included slippage (85.9%), skin irritation (75.8%), and saw-related injuries (35.9%). Clubfoot management variations exist in orthotics, tenotomy indications and practices, and cast material. Casting complications continue to be a problem. Further studies are warranted to determine if certain practices predispose patients to specific complications.

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Section: Introductionmentioning

confidence: 99%

Current Clubfoot Practices: POSNA Membership Survey

et al. 2023

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“…Twenty articles mentioned skin irritation, sensitivity, and breakdown. [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] Discomfort, pain, and increased crying frequency • Increased irritability 15,21,23,33,47,48 • Compromised sleep due to nighttime use 16,17,36,41 • Children with a higher level of motivation 58 Experience of self & time functions (b 180)…”

Section: Body Functions/body Structuresmentioning

confidence: 99%

“…• Skin irritation: Skin breakdown, skin sensitivity, blisters, ulcerations, abrasions, red spots, pressure sores, and chronic skin problems [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]86 •…”

Section: Body Functions/body Structuresmentioning

confidence: 99%

“…• Locally produced orthotics were manufactured at a lower cost 21 • Cost covered by source other than user 24,32,64 • Donation of outgrown shoes 29,50 • Nearby healthcare facility 24 • Involvement of children in the orthotic making process 27,49 • Good parental education about the importance of compliance 21,28,33,50,61,75,81 Products and Technology (e 1151) • Orthotic design • Heavy/not flexible 46,55 • Improper fit (i.e. : loose, feet slipped out of the orthotic) 20,23,26,30,46,48,53,71,76 • Aesthetics 36,55,82 • Device cracking 24,37 • Sensor to measure compliance 79 • Orthotics were reported to be inconvenient 26,82,89 • Do not fit in the car seat 67 • Difficulty bathing the child 67 • Difficulty holding the child 44 • Difficulty donning and doffing 15,19,41,42,46,48,55,<...…”

Section: Icf Subcategories (Code)mentioning

confidence: 99%

“…39,[70][71][72][73] Important considerations to facilitate compliance with orthotic use include using of a variety of communication formats (e.g. text messaging and web conferencing), 21,30,71,74,75 listening to parental beliefs, 62 and explaining the treatment to children as they get older. 71 A variety of universal barriers were identified within the subcategory of services, systems, and policies.…”

Section: Environmental Contextual Factorsmentioning

confidence: 99%

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Barriers and facilitators to lower extremity orthotic compliance in the pediatric population: A scoping review of the literature

Marcotte

Ferri

Xue

et al. 2022

Prosthetics &Amp; Orthotics International

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Despite the purported benefits of lower extremity orthotics in the literature, pediatric compliance rates remain low. This scoping review synthesized the available literature regarding barriers and facilitators to lower extremity orthotic compliance in the pediatric population using the framework of the International Classification of Functioning, Disability and Health: Children and Youth (ICF). A comprehensive search of MEDLINE, EMBASE, and CINAHL was conducted on May 11, 2021, and of PsycInfo on May 12, 2021. Article reference lists and gray literature were also searched. A total of 81 articles were included. Factors described in at least four articles were labeled as universal barriers or facilitators. In the International Classification of Functioning, Disability and Health: Children and Youth domain of Body Functions/Body Structures, universal barriers were present in the global mental functions, experience of self and time, sensory functions, function of joints and bones, and structures related to the skin subcategories, with no universal facilitators identified. For the Activity Limitations/Participation Restrictions domain, one universal facilitator was identified in the mobility subcategory. In the Environmental Contextual Factors domain, universal barriers were found in the attitudes of immediate and extended family and societal attitude subcategories, with both universal barriers and facilitators found in support & relationships: immediate and extended family, support and relationships: health professionals, services, systems, and policies, and products and technology. The reviewed literature strongly emphasizes the importance of proper orthotic fit and comfort, and the child’s experience of self, for lower extremity orthotic compliance, along with multiple environmental factors.

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Early Radiographic Characteristics of the Lateral Talocalcaneal Angle and its Predictive Significance for Relapse in Patients With Idiopathic Clubfoot Treated With the Ponseti Method

Li,

Xun,

et al. 2024

The Journal of Foot and Ankle Surgery

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Early developmental milestones in patients with idiopathic clubfoot treated by Ponseti method

Cited by 7 publications

References 24 publications

Current Clubfoot Practices: POSNA Membership Survey

Current Clubfoot Practices: POSNA Membership Survey

Barriers and facilitators to lower extremity orthotic compliance in the pediatric population: A scoping review of the literature

Early Radiographic Characteristics of the Lateral Talocalcaneal Angle and its Predictive Significance for Relapse in Patients With Idiopathic Clubfoot Treated With the Ponseti Method

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