TY - JOUR
T1 - Clubfoot treatment
T2 - Ponseti and french functional methods are equally effective
AU - Faulks, Shawne
AU - Richards, B. Stephens
PY - 2009/5
Y1 - 2009/5
N2 - Over the past 15 years, the reemergence of nonoperative treatment of clubfeet throughout the world has been profound. Two methods have been utilized-the Ponseti method and, to a lesser extent, the French functional method. Our review presents one institution's experience using both methods. Satisfactory initial correction was achieved in 95% of idiopathic clubfeet, regardless of method. However, maintenance of the correction was challenging as relapses occurred in 37% of feet treated by the Ponseti method and 29% of feet treated by the French functional method. At an average 4.3 year followup, using either method, posteromedial releases were avoided in 84% of our patients. Using gait analysis to evaluate the function of children treated with these techniques, there was no difference in cadence parameters between the two groups. More of the children treated with the French method walked with knee hyperextension, a mild equinus gait, and mild footdrop. In contrast, more of the patients in the Ponseti group demonstrated mildly increased stance-phase dorsiflexion and a calcaneus gait. Level of Evidence: Level V, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
AB - Over the past 15 years, the reemergence of nonoperative treatment of clubfeet throughout the world has been profound. Two methods have been utilized-the Ponseti method and, to a lesser extent, the French functional method. Our review presents one institution's experience using both methods. Satisfactory initial correction was achieved in 95% of idiopathic clubfeet, regardless of method. However, maintenance of the correction was challenging as relapses occurred in 37% of feet treated by the Ponseti method and 29% of feet treated by the French functional method. At an average 4.3 year followup, using either method, posteromedial releases were avoided in 84% of our patients. Using gait analysis to evaluate the function of children treated with these techniques, there was no difference in cadence parameters between the two groups. More of the children treated with the French method walked with knee hyperextension, a mild equinus gait, and mild footdrop. In contrast, more of the patients in the Ponseti group demonstrated mildly increased stance-phase dorsiflexion and a calcaneus gait. Level of Evidence: Level V, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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U2 - 10.1007/s11999-009-0754-5
DO - 10.1007/s11999-009-0754-5
M3 - Article
C2 - 19242767
AN - SCOPUS:64849096180
SN - 0009-921X
VL - 467
SP - 1278
EP - 1282
JO - Clinical orthopaedics and related research
JF - Clinical orthopaedics and related research
IS - 5
ER -