ÑCHILDREN'S ORTHOPAEDICS An accelerated Ponseti versus the standard Ponseti method A PROSPECTIVE RANDOMISED CONTROLLED TRIAL

The initial median Pirani score was 5.5 (95% confidence interval 4.5 to 6.0) in the accelerated group and 5.0 (95% confidence interval 4.0 to 5.0) in the standard control group. The scores decreased by an average 4.5 in the accelerated group and 4.0 in the control group. There was no significant difference in the final Pirani score between the two groups (chi-squared test, p = 0.308). The median number of treatment days in plaster was 16 in the accelerated group and 42 in the control group (p < 0.001). Of the 19 patients in the accelerated group, three required plaster treatment for more than 21 days and were then assigned to the standard control method. Of the 40 patients, 36 were followed for a minimum of six months. These results suggest that comparable outcomes can be achieved with an accelerated Ponseti method. The ability to complete all necessary manipulations within a three-week period facilitates treatment where patients have to travel long distances.

[1]  A. Siapkara,et al.  Congenital talipes equinovarus: a review of current management. , 2007, Journal of Bone and Joint Surgery-british Volume.

[2]  C. Walker,et al.  Early clubfoot recurrence after use of the Ponseti method in a New Zealand population. , 2007, The Journal of bone and joint surgery. American volume.

[3]  J. Morcuende,et al.  Correction of neglected idiopathic club foot by the Ponseti method. , 2007, The Journal of bone and joint surgery. British volume.

[4]  Lori A Dolan,et al.  Results of an Accelerated Ponseti Protocol for Clubfoot , 2005, Journal of pediatric orthopedics.

[5]  E. Kaunda,et al.  Incidence and Patterns of Congenital Talipes Equinovarus (Clubfoot) Deformity At Queen Elizabeth Central Hospital, Banter, Malawi. , 2004 .

[6]  Lori A Dolan,et al.  Radical reduction in the rate of extensive corrective surgery for clubfoot using the Ponseti method. , 2004, Pediatrics.

[7]  W. Lehman,et al.  Predicting the Need for Tenotomy in the Ponseti Method for Correction of Clubfeet , 2003, Journal of pediatric orthopedics.

[8]  M. Macnicol.  The management of club foot: issues for debate. , 2003, The Journal of bone and joint surgery. British volume.

[9]  S. Pirani,et al.  Magnetic resonance imaging study of the congenital clubfoot treated with the Ponseti method. , 2001, Journal of pediatric orthopedics.

[10]  W. Mackenzie,et al.  An independent assessment of two clubfoot-classification systems. , 1998, Journal of pediatric orthopedics.

[11]  Ignacio V. Ponseti,et al.  Congenital Clubfoot: Fundamentals of Treatment , 1996 .

[12]  F. Dietz,et al.  Treatment of idiopathic clubfoot. A thirty-year follow-up note. , 1995, The Journal of bone and joint surgery. American volume.

[13]  C. Chung,et al.  Genetic and epidemiological studies of clubfoot in Hawaii: ascertainment and incidence. , 1969, American journal of human genetics.

[14]  S J Laaveg,et al.  Long-term results of treatment of congenital club foot. , 1980, The Journal of bone and joint surgery. American volume.