Remote monitoring of clubfoot treatment with digital photographs in low resource settings: Is it accurate?

Smythe, Tracey; Nogaro, Marie-Caroline; Clifton, Laura J.; Mudariki, Debra; Theologis, Tim; Lavy, Chris

doi:10.1371/journal.pone.0232878

Cited by 4 publications

(3 citation statements)

References 17 publications

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“…However, telemedicine-oriented patient education may well solve the problem [37,61,62]. Studies conducted for virtual consultations for orthopedics usually focus on new solutions and technologies [59,[63][64][65][66][67][68][69], patient and clinician satisfaction [4,24,26,46,49,[70][71][72][73][74][75][76][77], clinical outcome measures [78][79][80][81][82], and cost analysis of traditional versus teleconsultation [82][83][84][85][86][87].…”

Section: Discussionmentioning

confidence: 99%

Orthopedic Telemedicine Outpatient Practice Diagnoses Set during the First COVID-19 Pandemic Lockdown—Individual Observation

Glinkowski

2022

IJERPH

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The COVID-19 pandemic has caused a substantial intensification of the telemedicine transformation process in orthopedics since 2020. In the light of the legal regulations introduced in Poland, from the beginning of the SARS-CoV-2 pandemic, physicians, including orthopedic surgeons, have had the opportunity to conduct specialist teleconsultations. Teleconsultations increase epidemiological safety and significantly reduce the exposure of patients and medical staff to direct transmission of the viral vector and the spread of infections. The study aimed to describe diagnoses and clinical aspects of consecutive orthopedic teleconsultations (TC) during the pandemic lockdown. The diagnoses were set according to the International Classification of Diseases (ICD-10). Hybrid teleconsultations used smartphones and obligatory Electronic Health Record (EHR) with supplemental voice, SMS, MMS, Medical images, documents, and video conferencing if necessary. One hundred ninety-eight consecutive orthopedic teleconsultations were served for 615 women and 683 men (mean age 41.82 years ± 11.47 years). The most frequently diagnosed diseases were non-acute orthopedic disorders “M” (65.3%) and injuries “S” (26.3%). Back pain (M54) was the most frequent diagnosis (25.5%). Although virtual orthopedic consultation cannot replace an entire personal visit to a specialist orthopedic surgeon, in many cases, teleconsultation enables medical staff to continue to participate in providing medical services at a sufficiently high medical level to ensure patient and physician. The unified approach to TC diagnoses using ICD-10 or ICD-11 may improve further research on telemedicine-related orthopedics repeatability. Future research directions should address orthopedic teleconsultations’ practical aspects and highlight legal, organizational, and technological issues with their implementations.

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Section: Discussionmentioning

confidence: 99%

Orthopedic Telemedicine Outpatient Practice Diagnoses Set during the First COVID-19 Pandemic Lockdown—Individual Observation

Glinkowski

2022

IJERPH

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“…Another opportunity is that the data can be shared remotely with experts and study groups for treatment monitoring. An interesting study has been done by Smythe et al 111 They have shown that remote monitoring for the assessment of clubfoot treatment using photographs has massive potential in low-resource settings. However, there is a need to define protocols for data acquisition to increase the effectiveness of such technologies.…”

Section: Treatment Challenges: Contemporary Engineeringmentioning

confidence: 99%

Clubfoot: Review on Assessment, Treatment, Challenges, and Engineering Aspects

Singh¹,

Mali²

2022

J Prosthet Orthot

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IntroductionClubfoot, mainly CTEV, is a complex three-dimensional deformity challenging physicians from ancient times. Among a thousand babies born, one to six suffer from clubfoot deformity; that is, in India alone, around 35,000 need treatment for clubfoot annually. This review summarizes the various practices of clubfoot assessment, noninvasive treatment, and engineering aspects of clubfoot treatment. The shortcomings of assessment methods and challenges with implementation of treatment methods are also presented.MethodsA narrative review of all related research papers available to authors was carried out.ResultsVarious clubfoot assessment methods have been developed to help physicians understand the severity of the problem and predict treatment parameters. The Pirani score and Dimeglio score are used predominantly for the assessment of deformity. However, these methods suffer from implementation-related limitations. Noninvasive methods, namely, Kite's method, functional physiotherapy method, and Ponseti method, are used in practice for treatment. The Ponseti method is the most popular with parents and physicians and is considered the gold standard for the treatment of clubfoot. However, it also suffers from various implementation issues, like treatment cost and lack of experts, particularly in low- and middle-income countries (LMICs). Engineers are using various technologies like computer-aided design (CAD)/computer-aided engineering (CAE) and additive manufacturing for modeling and analysis of clubfoot. Engineers have also attempted to develop corrective and maintenance orthosis for CTEV treatment.ConclusionsBecause newer and newer technologies are becoming accessible for interdisciplinary use, there is a need to apply contemporary technologies, especially to develop a corrective orthosis so that the current challenges of clubfoot assessment and treatment are addressed. The corrective orthosis should be based on Dr Ponseti's insights into clubfoot biomechanics.Clinical RelevanceThere is a need to explore contemporary technologies like data acquisition and CAD/CAE to address CTEV assessment–related issues. A corrective orthosis based on the understanding of the foot biomechanics for treatment can solve the various implementation-related challenges of the Ponseti method, particularly in low-resource settings.

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“…It require extensive orthopedic care. The muscular and bone level tendinous structures are representative of the idiopathic foot disease [3][4] . The midfoot cavus, hindfoot varus, and a hindfoot equinus are commonly observed in the idiopathic-club foot.…”

Section: Introductionmentioning

confidence: 99%

Neglected Clubfoot; Surgical Treatment Algorithm Evaluation in Tertiary Care Hospital of Pakistan

Arsalan¹,

Kashmiri²,

Khan³

et al. 2022

PJMHS

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Background: The 1 in every 1000 infants are affected by the idiopathic club-foot. It is most commonly observed among the people living in the low middle income countries. Objective: The study was carried out to evaluate the surgical treatment algorithm in case of neglected clubfoot among patients admitted at tertiary care unit. Study design: It is a cohort based retrospective study conducted for the duration of six months from January 2022 to June 2022. Material and Methods: The study was conducted on the 40 patients presented with clubfoot at the tertiary health unit, Khyber Teaching Hospital, Peshawar, were included. The patients mean age was 11 years. The range of patient’s age was from 3 to 25 years. 13 patients went through bilateral intervention. And among these 40 patients there were 15 had received unilateral intervention for each foot. The basic features of the patients were recorded. There were 3 groups made containing operated clubfeet patients, first group included 15 patients, second and third group included 12 patients each. Results: There were 29 patients that received only one follow-up visit. The patients visited their doctors for the first year after surgery but then the visiting attendance became irregular afterwards. The altered ICFSG data was compared for only those patients that completed at least three follow-up visits. The variation between the score of participants between group 1 and 2 was not significant statitically. Conclusion: In case of neglected club-foot condition, PMR has shown excellent to fair results in patients especially children. Therefore, it can be proposed that PMR can be used to lessen the burden of neglected club-foot in the LMICs as it also has no side effects. There is a strong link between age and the surgical outcomes so the treatment must be done as soon as possible. Keywords: Club-foot, PMR, ICFSG data, surgical outcomes.

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Remote monitoring of clubfoot treatment with digital photographs in low resource settings: Is it accurate?

Cited by 4 publications

References 17 publications

Orthopedic Telemedicine Outpatient Practice Diagnoses Set during the First COVID-19 Pandemic Lockdown—Individual Observation

Orthopedic Telemedicine Outpatient Practice Diagnoses Set during the First COVID-19 Pandemic Lockdown—Individual Observation

Clubfoot: Review on Assessment, Treatment, Challenges, and Engineering Aspects

Neglected Clubfoot; Surgical Treatment Algorithm Evaluation in Tertiary Care Hospital of Pakistan

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