Has the Rate of Extensive Surgery to Treat Idiopathic Clubfoot Declined in the United States?

Zionts, Lewis E.; Zhao, Guofen; Hitchcock, Kristin; Maewal, Jaya; Ebramzadeh, Edward
April 2010
Journal of Bone & Joint Surgery, American Volume;Apr2010, Vol. 92-A Issue 4, p882
Academic Journal
Background: In the late 1990s, renewed interest emerged in less invasive treatment options, most notably the Ponseti method, to correct idiopathic clubfoot deformity. Recently, reports from several centers have demonstrated that such minimally invasive techniques may be used reliably to correct this complex deformity. The present study sought to determine whether the rate of extensive surgical releases to treat idiopathic clubfoot in the United States has decreased. Methods: We used data from the Centers for Disease Control and Prevention and the Nationwide Inpatient Sample to determine the number of live births, the number of patients diagnosed with clubfoot, and the number of extensive surgical releases that were performed each year from 1996 to 2006. The trends over time were evaluated with use of regression analysis, and changes in frequency were analyzed with use of time series analysis. The percentage of clubfeet that were treated with surgery in each year was calculated by dividing the number of surgical release procedures by the number of clubfoot diagnoses. Results: Between 1996 and 2006, the estimated number of patients under six months of age diagnosed with clubfoot remained fairly constant, averaging 2140 infants per year. The linear equation estimated a slight decrease of approximately thirty-one infants with clubfoot per year (R2 = 0.51, p < 0.05). In contrast, in the same decade, the estimated number of surgical releases performed in patients less than twelve months of age decreased substantially, from 1641 releases in 1996 to 230 releases in 2006. The linear equation estimated a decrease of approximately 157 surgical releases per year (R2 = 0.83, p < 0.05). The trend analysis indicated that the percentage of clubfeet treated with surgical release generally decreased over time at a rate of 6.7% per year, decreasing from just over 70% in 1996 to just over 10% in 2006 (R2 = 0.81, p < 0.05). Conclusions: In the United States between 1996 and 2006, the rate of extensive surgery to treat idiopathic clubfoot in patients less than twelve months old decreased substantially. This trend is likely due to an increased use of less invasive techniques, such as the Ponseti method, which a growing body of evidence has shown to be a viable treatment option for clubfoot.


Related Articles

  • CORR Insights(®): What Is the Radiographic Prevalence of Incidental Kienböck Disease? Calfee, Ryan; Calfee, Ryan P // Clinical Orthopaedics & Related Research;Mar2016, Vol. 474 Issue 3, p814 

    The author presents a commentary on the article What Is the Radiographic Prevalence of Incidental Kienböck disease.? by Van Leeuwen and colleagues. Topics include occurrence of avascular necrosis of the lunate without associated symptoms, advanced disease progression which is more likely to...

  • What is the most effective treatment for external genital warts. French, Linda; Nashelsky, Joan // Journal of Family Practice;Apr2002, Vol. 51 Issue 4, p313 

    The article discusses the most effective treatment for external genital warts. Among the beneficial nonsurgical treatments in eradicating genital warts are podofilox and intralesional interferon. Both electrosurgery and surgical excision are superior to podophyllin in clinical trials, although...

  • CDC Releases Recommendations on New Treatment for Latent Tuberculosis Infection.  // American Family Physician;1/1/2012, Vol. 85 Issue 1, p8 

    The article presents recommendations released by the U.S. Centers for Disease Control and Prevention (CDC) in December 2011 that provide guidance on the administration of a new 12-dose regimen for tuberculosis preventive therapy that reportedly shortens treatment from nine months to 12 weeks.

  • CDC outlines 2014 global health threats. Newman, Elizabeth // McKnight's Long-Term Care News;Feb2014, Vol. 35 Issue 2, p10 

    The article discusses the objectives of the U.S. Centers for Disease Control and Prevention (CDC) to work on improving antibiotic use, gathering data on antibiotic resistant infections, preventing infections and developing diagnostic tests to track resistance.

  • Blunt suture needles and percutaneous injuries.  // American Family Physician;4/1/1997, Vol. 55 Issue 5, p1982 

    Reports that the Centers for Disease Control and Prevention undertook a study to evaluate the safety and efficacy of the use of blunt suture needles during gynecologic surgeries. How the study was conducted; Method used in the study; Results of the study.

  • Risk Factors of Surgical Site Infection After Hepatectomy for Liver Cancers. Kobayashi, Shin; Gotohda, Naoto; Nakagohri, Toshio; Takahashi, Shinichiro; Konishi, Masaru; Kinoshita, Taira // World Journal of Surgery;Feb2009, Vol. 33 Issue 2, p312 

    Risk factors of surgical site infection (SSI) after hepatectomy under the guideline of Centers for Disease Control and Prevention (CDC) are not well examined. Hospital records of consecutive patients who underwent hepatectomy without biliary reconstruction for liver cancers were reviewed...

  • Incidence of Surgical Site Infection After Spine Surgery: What Is the Impact of the Definition of Infection? Nota, Sjoerd; Braun, Yvonne; Ring, David; Schwab, Joseph // Clinical Orthopaedics & Related Research;May2015, Vol. 473 Issue 5, p1612 

    Background: Orthopaedic surgical site infections (SSIs) can delay recovery, add impairments, and decrease quality of life, particularly in patients undergoing spine surgery, in whom SSIs may also be more common. Efforts to prevent and treat SSIs of the spine rely on the identification and...

  • A Comparison of Two Nonoperative Methods of Idiopathic Clubfoot Correction The Ponseti Method and the French Functional (Physiotherapy) Method. Steinman, Suzanne; Richards, B. Stephens; Faulks, Shawne; Kaipus, Kim // Journal of Bone & Joint Surgery, American Volume;Oct2009 Supplement 2, Vol. 91-A Issue 2, p299 

    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...

  • Latent tuberculosis: revised treatment guidelines. Weir, Erica; Fisman, David N. // CMAJ: Canadian Medical Association Journal;10/28/2003, Vol. 169 Issue 9, p937 

    Presents the revised treatment guidelines issued by the American Thoracic Society and the U.S. Centers for Disease Control and Prevention for tuberculosis (TB). Factors that increased the risk of reactivation of TB; Details of the use of Mantoux tuberculin skin test in TB diagnosis; Consequence...


Read the Article


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

Try another library?
Sign out of this library

Other Topics