TITLE

A Comparison of Two Nonoperative Methods of Idiopathic Clubfoot Correction: The Ponseti Method and the French Functional (Physiotherapy) Method

AUTHOR(S)
Richards, B. Stephens; Faulks, Shawne; Rathjen, Karl E.; Karol, Lori A.; Johnston, Charles E.; Jones, Sarah A.
PUB. DATE
November 2008
SOURCE
Journal of Bone & Joint Surgery, American Volume;Nov2008, Vol. 90-A Issue 11, p2313
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: In the treatment of idiopathic clubfeet, the Ponseti method and the French functional method have been successful in reducing the need for surgery. The purpose of this prospective study was to compare the results of these two methods at one institution. Methods: Patients under three months of age with previously untreated idiopathic clubfeet were enrolled. All feet were rated for severity prior to treatment. After both techniques had been described to them, the parents selected the treatment method. Outcomes at a minimum of two years were classified as good (a plantigrade foot with, or without, a heel-cord tenotomy), fair (a plantigrade foot that had or needed to have limited posterior release or tibialis anterior transfer), or poor (a need for a complete posteromedial surgical release). Two hundred and sixty-seven feet in 176 patients treated with the Ponseti method and 119 feet in eighty patients treated with the French functional method met the inclusion criteria. Results: The patients were followed for an average of 4.3 years. Both groups had similar severity scores before treatment. The initial correction rates were 94.4% for the Ponseti method and 95% for the French functional method. Relapses occurred in 37% of the feet that had initially been successfully treated with the Ponseti method. One-third of the relapsed feet were salvaged with further nonoperative treatment, but the remainder required operative intervention. Relapses occurred in 29% of the feet that had been successfully treated with the French functional method, and all required operative intervention. At the time of the latest follow-up, the outcomes for the feet treated with the Ponseti method were good for 72%, fair for 12%, and poor for 16%. The outcomes for the feet treated with the French functional method were good for 67%, fair for 17%, and poor for 16%. Conclusions: Nonoperative correction of an idiopathic clubfoot deformity can be maintained over time in most patients. Although there was a trend showing improved results with use of the Ponseti method, the difference was not significant. In our experience, parents select the Ponseti method twice as often as they select the French functional method. Level of Evidence: Therapeutic Level II. See Instructions to Authors for a complete description of levels of evidence.
ACCESSION #
35282005

 

Related Articles

  • Kids walk straight. Parents breathe easy.  // Fast Company;Oct2014, Issue 189, p144 

    The article offers brief information on a lightweight plastic brace to treat clubfoot in children, called Miraclefeet, designed by Stanford graduate students Jeffrey Yang and Ian Connolly.

  • The Drop Toe Sign: An Indicator of Neurologic Impairment in Congenital Clubfoot. Eric Edmonds; Steven Frick // Clinical Orthopaedics & Related Research;May2009, Vol. 467 Issue 5, p1238 

    Abstract  Nine patients presenting during infancy were identified with clubfeet and absent anterior and lateral compartment functions. We considered these to be neurogenic clubfeet. All patients had the drop toe sign: resting posture of the toes in plantarflexion and absent active...

  • The Ponseti method for the treatment of congenital club foot: review of the current literature and treatment recommendations. Radler, Christof // International Orthopaedics;Sep2013, Vol. 37 Issue 9, p1747 

    The Ponseti method has become the gold standard of care for the treatment of congenital club foot. Despite numerous articles in MEDLINE reporting results from around the globe there are still crucial details of the Ponseti method which seem to be less commonly known or considered. The Ponseti...

  • Clubfoot in Malawi: local theories of causation. Bedford, K. Juliet A.; Chidothi, Paul; Sakala, Harris; Cashman, John; Lavy, Chris // Tropical Doctor;Apr2011, Vol. 41 Issue 2, p65 

    This paper examines local theories of the causation of club foot expressed by the guardians of children undergoing treatment at clinics run by the Malawi National Clubfoot Programme (MNCP). Core data was collected and analysed using qualitative methodologies of critical medical anthropology....

  • The posterior talofibular ligament: an anatomical study with clinical implication in clubfoot surgery. Courvoisier, Aurélien; Vialle, Raphaäl; Thévenin-Lemoine, Camille; Mary, Pierre; Damsin, Jean-Paul // Surgical & Radiologic Anatomy;Nov2008, Vol. 30 Issue 8, p633 

    The role of the posterior talofibular ligament (PTFL) in the clubfoot deformity remains unclear. We conducted an anatomical study to precise its topography and role in maintaining tibiotalar equinus in patients with clubfoot deformity. Ten ankles were dissected using a wide posterior exposure....

  • Gait Analysis of Children Treated for Clubfoot with Physical Therapy or the Ponseti Cast Technique. El-Hawary, Ron; Karol, Lori A.; Jeans, Kelly A.; Richards, B. Stephens // Journal of Bone & Joint Surgery, American Volume;Jul2008, Vol. 90-A Issue 7, p1508 

    Background: Currently, clubfoot is initially treated with nonoperative methods including the Ponseti cast technique and the French functional physical therapy program. Our goal was to evaluate the function of children treated with these techniques. Methods: We reviewed the cases of 182 patients...

  • Neglected Idiopathic Bilateral Clubfoot Successfully Treated with the Ponseti Method. de Podestá Haje, Davi // Case Connector;2013, Vol. 3 Issue 1, p1 

    The article presents a case study of a patient referred to a public hospital with previously untreated bilateral clubfoot. Foot manipulation and casting were conducted as described by Ponseti. It reveals that the modification of Ponseti technique in neglected cases is possible, performing the...

  • Native American children are at greater risk of clubfoot recurrence.  // Podiatry Now;Apr2009, Vol. 12 Issue 4, p19 

    The article reports on the findings of a study by U.S. researchers and published in the "Journal of Bone and Joint Surgery" (JBJS) why Native American children living in rural areas are at an increased risk of clubfoot recurrence after treatment using the Ponsetti method. Among the factors that...

  • Initial results of SpineCor treatment of Adolescent Idiopathic Scoliosis in Seville, Spain. Miller, A. Vera // Scoliosis (17487161);2009 Supplement 2, Vol. 4, Special section p1 

    Objective The objective of this study was to determine the effectiveness of the SpineCor brace in patients with adolescent idiopathic scoliosis treated in Seville, Spain. Background The SpineCor brace is used at St. Justine Children's Hospital in Montréal. Their results claim that SpineCor is...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics