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

Hemo, Yoram; Segev, Eitan; Yavor, Ariella; Ovadia, Dror; Wientroub, Shlomo; Hayek, Shlomo

doi:10.1007/s11832-010-0321-3

Cited by 25 publications

(34 citation statements)

References 23 publications

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“…1A). 24) The Mitchell-Ponseti brace which was developed by John Mitchell and Ignacio Ponseti includes detachable shoes and soft silicone inserts with a leather support and three leather straps 24,31). The Mitchell-Ponseti brace may be more attractive to some parents and more comfortable for children, but it does not provide better clinical results than the Denis Browne bar (Fig.…”

Section: The Mechanism By Which the Brace Prevents A Relapsementioning

confidence: 99%

“…1B and C). 31) Chen et al7) described an articulated FAO design that allows active flexion and extension of each leg separately while maintaining the necessary external rotation of the foot. The articulating FAO is well tolerated by patients and results in a higher compliance rate and a lower complication rate than the traditional FAO 7).…”

Section: The Mechanism By Which the Brace Prevents A Relapsementioning

confidence: 99%

“…Many methods have been used to improve the compliance, such as reminding or motivating the parents14) and modifying the brace 7). But no level of motivation can compensate for an imperfect brace 24,31). Currently, the brace protocol is identical for all of the patients.…”

Section: Conclusion and Future Prospectsmentioning

confidence: 99%

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Relapse of Clubfoot after Treatment with the Ponseti Method and the Function of the Foot Abduction Orthosis

et al. 2014

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Ponseti clubfoot treatment has become more popular during the last decade because of its high initial correction rate. But the most common problem affecting the long-term successful outcome is relapse of the deformity. Non-compliance with Ponseti brace protocol is a major problem associated with relapse. Although more comfortable braces have been reported to improve the compliance, they all have the same design and no significant changes have been made to the protocols. After refinement in the Ponseti method and emphasizing the importance of brace to parents, the relapse rate has been markedly decreased. Nevertheless, there are patients who do not have any recurrence although they are not completely compliant with the brace treatment, whereas other patients have a recurrence even though they are strictly compliant with the brace treatment. The aim of this article is to review the relapse of clubfoot and the function of the brace and to develop an individualized brace protocol for each patient by analyzing the mechanism of the brace and the biomechanical properties of muscles, tendons, and ligaments.

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Section: The Mechanism By Which the Brace Prevents A Relapsementioning

confidence: 99%

Section: The Mechanism By Which the Brace Prevents A Relapsementioning

confidence: 99%

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Relapse of Clubfoot after Treatment with the Ponseti Method and the Function of the Foot Abduction Orthosis

et al. 2014

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“…A study comparing a Denis Brown orthosis with an ankle foot orthosis reveals that patients wearing the Denis Brown orthosis have significantly fewer recurrences [22]. However, Hemo et al, find no significant difference between Denis Brown and Mitchell braces after a minimum two-year follow-up period [23]. Furthermore, there is no scientific proof about the timing of ending the use of orthoses.…”

Section: Citation: Sayit E Sayit At (2015) Clinical Experiences and mentioning

confidence: 99%

Clinical Experiences and Midterm Results of the Treatment of Clubfoot with the Ponseti Method

Sayıt¹

2015

ORP

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IntroductionTalipes Equinovarus (TEV) is a fairly common birth defect in which males are affected twice as often as females and 50% of the cases show bilateral defects [1]. In the United States, the overall prevalence of clubfoot is 1.29 per 1000 live births [2].Although the Ponseti method of treatment was first described many years ago, it recently became the standard method of treating TEV due to its successful long-term results.Several scoring methods have been developed to assess the foot before, during, and after treatment for TEV. For this study, we incorporated data from two of the most commonly used scoring systems, Dimeglio and Pirani. Dimeglio and his colleagues divide a clubfoot deformity into four measurable anatomical features, or subgroups, which are scored on a scale of 20 points. These subgroups are equinus in the sagittal plane, varus deviation in the frontal plane, derotation around the talus of the calcaneo-forefoot block, and adduction of the forefoot on the hindfoot in the horizontal plane. Each subgroup is assessed in severity from 1 to 4 points. In the presence of a posterior or medial fold, extreme cavus and/or muscle weakness, another point is added to each category for a possible total of 5 points [3]. The second scale, the Pirani scoring system, evaluates six parameters of the foot separately as normal (0 points), moderate to severe (0.5 points), or severe (1 point). These anatomical parameters are the curvature of the lateral border of the foot, degree of medial skin fold, covering of the head of talus, degree of posterior skin fold, equinus or extreme plantar flexion at the ankle joint, and the presence of a free heel [4]. The Dimeglio and Pirani scoring systems are useful in evaluating the degree of correction of the foot as well as the potential for the prognosis of the disease.In the following study, we examine the components of the Ponseti method and share our experiences and results. Materials and MethodsIn this study, we analyzed 92 feet from a total of 60 patients with idiopathic talipes equinovarus. Of the total, 43 patients were males and 17 were females. All patients started treatment with the Ponseti method on the same day that they presented to our clinic. Patients with accompanying anomalies or dysmelias were excluded. The patients' families were given detailed information regarding the clubfoot deformation as well as the Ponseti treatment process, other available treatment options, the usage of orthoses, possible complications, and the potential prognosis. We explained how crucial the family's compliance and cooperation are to the success of the treatment and collected the family's fully informed consent.For casting the legs after manipulation, we used the classic casting method of combining 5 or 10 cm of cotton with plaster of Paris. No synthetic casting materials were used. A trained orthopedic surgeon and a resident performed the Ponseti manipulations. We encouraged feeding of the infants prior to cast molding and placement. HSOA Journal of Orthopedic Research and P...

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“…For the first three months after the surgery it is recommended to wear up to 24 hours a day a foot abduction orthosis based on Denis-Brown splint with external rotation of 70 degrees in the affected foot, and 45 degrees in the healthy limb. After this time daily wear of the splint can be reduced, although the orthotic must be used up to 4 years of age [17][18][19][20][21][22][23].…”

Section: The Methods Of Congenital Clubfoot Treatment By Ponsetimentioning

confidence: 99%

Comparison of two treatment methods of congenital clubfoot in the orthopaedists’ opinion

Okoński¹,

Misztal-Okońska

Okoński

et al. 2017

Polish Journal of Public Health

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Introduction. Clubfoot is the second most common birth defect of the lower limb. In Europe (including Poland) it concerns about 1-2 in 1000 newborns. What is characteristic for a clubfoot, is change in the foot shape and its impairment with preserving anatomical structures. Aim. The aim of this work is to gather opinions of orthopedic physicians on the effectiveness of the two methods used to treat congenital clubfoot: the Turco method and the Ponseti method. Material and methods. The research method used in the work was a diagnostic survey and research technique was the author’s questionnaire designed to gather opinions of orthopedic surgeons on the two methods of clubfoot treatment. The questionnaires were collected in the Orthopaedic Clinics in Lublin and Rzeszów, as well as during the specialization courses for orthopaedic surgeons in Lublin. Results. The most important advantages of the Ponseti method according to respondents are high clinical effectiveness (average 4.48) and short duration of hospitalization (average 4.31). While the most important disadvantages of the method is length of rehabilitation (average 2.85) and convalescence (average 2.36). Top assets of the Turco method in turn, according to respondents, are high clinical efficiency (average 2.92) and certainty of the patient’s recovery (2.74). In turn, the downsides of the Turco method according to the respondents are high invasiveness (average 4.11) and length of convalescence (average 3.87). Conclusion. The Ponseti method is the surveyed doctors’ preferred method of congenital clubfoot treatment.

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

Cited by 25 publications

References 23 publications

Relapse of Clubfoot after Treatment with the Ponseti Method and the Function of the Foot Abduction Orthosis

Relapse of Clubfoot after Treatment with the Ponseti Method and the Function of the Foot Abduction Orthosis

Clinical Experiences and Midterm Results of the Treatment of Clubfoot with the Ponseti Method

Comparison of two treatment methods of congenital clubfoot in the orthopaedists’ opinion

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