Is the modified Ponseti method effective in treating atypical and complex clubfoot? A systematic review

2021 ◽  
Author(s):  
Omar A. Al-Mohrej ◽  
Fawaz N. Alshaalan ◽  
Thamer S. Alhussainan
Keyword(s):  
Systematic Review ◽  
Ponseti Method

scholarly journals The Ponseti method in children with clubfoot after walking age – Systematic review and metanalysis of observational studies

PLoS ONE ◽  
2018 ◽  
Vol 13 (11) ◽  
pp. e0207153 ◽  
Author(s):  
Gabriel Ferraz Ferreira ◽  
Kelly Cristina Stéfani ◽  
Davi de Podestá Haje ◽  
Monica Paschoal Nogueira
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Ponseti Method ◽  
Walking Age

Congenital talipes equinovarus

2019 ◽  
Vol 101-B (6) ◽  
pp. 639-645 ◽  
Author(s):  
Y. Gelfer ◽  
S. Wientroub ◽  
K. Hughes ◽  
A. Fontalis ◽  
D. M. Eastwood
Keyword(s):  
Systematic Review ◽  
Ponseti Method ◽  
Assessment Methods ◽  
Major Surgery ◽  
Idiopathic Clubfoot ◽  
Congenital Talipes Equinovarus ◽  
Talipes Equinovarus ◽  
Minor Surgery ◽  
Meta Analyses

AimsThe Ponseti method is the benchmark treatment for the correction of clubfoot. The primary rate of correction is very high, but outcome further down the treatment pathway is less predictable. Several methods of assessing severity at presentation have been reported. Classification later in the course of treatment is more challenging. This systematic review considers the outcome of the Ponseti method in terms of relapse and determines how clubfoot is assessed at presentation, correction, and relapse.Patients and MethodsA prospectively registered systematic review was carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies that reported idiopathic clubfoot treated by the Ponseti method between 1 January 2012 and 31 May 2017 were included. The data extracted included demographics, Ponseti methodology, assessment methods, and rates of relapse and surgery.ResultsA total of 84 studies were included (7335 patients, 10 535 clubfeet). The relapse rate varied between 1.9% and 45%. The rates of relapse and major surgery (1.4% to 53.3%) and minor surgery (0.6% to 48.8%) both increased with follow-up time. There was high variability in the assessment methods used across timepoints; only 57% of the studies defined relapse. Pirani scoring was the method most often used.ConclusionRecurrence and further surgical intervention in idiopathic clubfoot increases with the duration of follow-up. The corrected and the relapsed foot are poorly defined, which contributes to variability in outcome. The results suggest that a consensus for a definition of relapse is needed. Cite this article: Bone Joint J 2019;101-B:639–645.

scholarly journals Influence of cast change interval in the Ponseti method: A systematic review

PLoS ONE ◽  
2018 ◽  
Vol 13 (6) ◽  
pp. e0199540 ◽  
Author(s):  
R. B. Giesberts ◽  
M. C. van der Steen ◽  
P. G. M. Maathuis ◽  
A. T. Besselaar ◽  
E. E. G. Hekman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ponseti Method

scholarly journals Results of Clubfoot Management Using the Ponseti Method: Do the Details Matter? A Systematic Review

2014 ◽  
Vol 472 (4) ◽  
pp. 1329-1336 ◽  
Author(s):  
Dahang Zhao ◽  
Hai Li ◽  
Li Zhao ◽  
Jianlin Liu ◽  
Zhenkai Wu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ponseti Method

scholarly journals The Ponseti Method in Children with Clubfoot after Walking Age: Systematic Review and Metanalysis

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0040
Author(s):  
Kelly Cristina Stéfani ◽  
Davi de Podestá Haje ◽  
Monica Paschoal Nogueira
Keyword(s):  
Systematic Review ◽  
Random Effects ◽  
Low Cost ◽  
Ponseti Method ◽  
Cochrane Library ◽  
Idiopathic Clubfoot ◽  
Complication Rates ◽  
Random Effects Model ◽  
Congenital Clubfoot ◽  
Walking Age

Category: Clubfoot Introduction/Purpose: The prevalence of untreated congenital clubfoot among children older than walking age is higher in developing countries due to limited resources for early care after birth. The Ponseti method represents an intervention option for older, untreated children. Methods: A metanalysis was conducted of observational studies selected through a systematic review of articles included in electronic databases (Medline, Scopus, Embase, Lilacs, and the Cochrane Library) until June 2017. A pooling analysis of proportions with 95% confidence intervals (CIs) and a publication bias assessment were performed as routine. Estimates of success, recurrence, and complication rates were weighted and pooled using the random effects model. Results: Twelve studies, including 654 feet diagnosed with congenital clubfoot in children older than walking age (older than 1 year old), were included for analysis. The rate of satisfactory outcomes found via a cluster metanalysis of proportions using the random effects model was 89% (95% CI = 0.82–0.94, p < 0.01), relative to the total analysed. The recurrence rate was 18% (95% CI = 0.14–0.24, p = 0.015), and the rate of casting complications was 7% (95% CI = 0.03–0.15, p = 0.19). Conclusion: Application of the Ponseti method in children with untreated idiopathic clubfoot older than walking age leads to satisfactory outcomes, has a low cost, and avoids surgical procedures likely to cause complications. The results obtained exhibited considerable heterogeneity.

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