Clubfoot treatment with Ponseti method—parental distress during plaster casting

Abstract Background: Clubfoot is one of the most prevalent musculoskeletal congenital defects. Gold standard treatment of idiopathic clubfoot is the conservative Ponseti method, including the reduction of deformity with weekly serial plaster casting and percutaneous Achilles tenotomy. It is well known that parents of children with severe and chronic illnesses are mentally stressed, but in recent studies regarding clubfoot treatment, parents were only asked about their satisfaction with the treatment. Largely unknown is parental distress before and during plaster casting in clubfoot.Therefore, we want to determinate first, how pronounced the parents' worries are before treatment and if they decrease during the therapy. Second, we hypothesized that parents faced with an extreme deformity (high Pirani-Score), reveal more distress, than parents whose children have a less pronounced deformity (low Pirani-Score). Therefore, we wanted to investigate weather the Pirani score correlates with the parents' mental resilience in relation to the therapy of the child as a global distress parameter.Methods: To answer this question, we developed a questionnaire with the following emphases: Physical capacity, mental resilience, motion score, parents score and child score with point scores 1 (not affected) to 6 (high affected). Subsequently, we interviewed 20 parents whose children were treated with clubfeet and determined the Pirani score of the infants at the beginning (T0) and at the end (TE) of the treatment with plaster casting.Results: High values were obtained in child score (Mean (M) = 3.11), motion score (M = 2.63) and mental resilience (M = 2.25) and. During treatment, mental resilience improved (p = 0.015) significantly. The Spearmann correlation coefficient between Pirani-Score (T0) and mental resilience (T0) is 0.21, so the initial hypothesis had to be rejected. Conclusion: The issues of the children are in the focus of parental worries concerning clubfoot treatment, especially the assumed future motion and the assumed ability to play with other children. Particular emphasis should be placed on educating parents about the excellent long-term results in the function of the treated feet especially as this topic shows the greatest parental distress.

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Clubfoot treatment with Ponseti method – Parental distress during plaster casting

10.21203/rs.3.rs-21711/v2 ◽

2020 ◽

Author(s):

Christian Walter ◽

Saskia Sachsenmaier ◽

Markus Wünschel ◽

Martin Teufel ◽

Marco Götze

Keyword(s):

Ponseti Method ◽

Long Term Results ◽

Congenital Defects ◽

Idiopathic Clubfoot ◽

Parental Distress ◽

Achilles Tenotomy ◽

Pirani Score ◽

Plaster Casting ◽

Initial Hypothesis ◽

Mental Resilience

Abstract Background Clubfoot is one of the most prevalent musculoskeletal congenital defects. Gold standard treatment of idiopathic clubfoot is the conservative Ponseti method, including the reduction of deformity with weekly serial plaster casting and percutaneous Achilles tenotomy. It is well known that parents of children with severe and chronic illnesses are mentally stressed, but in recent studies regarding clubfoot treatment, parents were only asked about their satisfaction with the treatment. Largely unknown is parental distress before and during plaster casting in clubfoot.Therefore, we want to determinate first, how pronounced the parents' worries are before treatment and if they decrease during the therapy. Second, we hypothesized that parents faced with an extreme deformity (high Pirani-Score), reveal more distress, than parents whose children have a less pronounced deformity (low Pirani-Score). Therefore, we wanted to investigate weather the Pirani score correlates with the parents' mental resilience in relation to the therapy of the child as a global distress parameter.Methods: To answer this question, we developed a questionnaire with the following emphases: Physical capacity, mental resilience, motion score, parents score and child score with point scores 1 (not affected) to 6 (high affected). Subsequently, we interviewed 20 parents whose children were treated with clubfeet and determined the Pirani score of the infants at the beginning (T0) and at the end (TE) of the treatment with plaster casting.Results High values were obtained in child score (Mean (M) = 3.11), motion score (M = 2.63) and mental resilience (M = 2.25). During treatment, mental resilience improved (p = 0.015) significantly. The Spearman correlation coefficient between Pirani-Score (T0) and mental resilience (T0) is 0.21, so the initial hypothesis had to be rejected.Conclusion The issues of the children are in the focus of parental worries concerning clubfoot treatment, especially the assumed future motion and the assumed ability to play with other children. Particular emphasis should be placed on educating parents about the excellent long-term results in the function of the treated feet especially as this topic shows the greatest parental distress.

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TL 18192 - Perspective on the Ponseti method for the treatment of clubfoot associated with amniotic band constriction syndrome

Scientific Journal of the Foot & Ankle ◽

10.30795/scijfootankle.2019.v13.1085 ◽

2019 ◽

Vol 13 (Supl 1) ◽

pp. 106S

Author(s):

Jordanna Maria Pereira Bergamasco ◽

Marcelo Chakkour ◽

Raoni Madeiro ◽

Marco Tulio Costa ◽

Ricardo Cardenuto Ferreira ◽

...

Keyword(s):

Daily Living ◽

Lymphatic System ◽

Ponseti Method ◽

Lower Limbs ◽

Deep Fascia ◽

Amniotic Band ◽

Achilles Tenotomy ◽

The Past ◽

Plaster Casting

Introduction: Amniotic band constriction syndrome is a rare anomaly with an incidence of approximately 1:15,000 live births. It manifests as fibrous amniotic bands involving the deep fascia and, depending on its depth, can compromise the venous and lymphatic system. The presence of fibrous amniotic bands in the lower limbs is strongly associated with foot malformations, and the prevalence of clubfoot under such conditions ranges from 12 to 56%. Clubfoot associated with amniotic band constriction syndrome is characterized by rigidity and edema and tends to respond poorly to conservative treatment. We present a series of cases of clubfoot associated with amniotic band constriction syndrome that were treated with manipulation and plaster casting using the Ponseti method. Methods: Over the past 10 years, we followed 19 patients with amniotic band constriction syndrome affecting the lower limbs. Of these patients, 6 had clubfoot, including 2 who were bilaterally affected. The 6 children in this series had constriction bands in Hennigan and Kuo zone 2. The 8 affected feet were rigid, with a mean Pirani score of 5.5 and Dimeglio III classification. Four extremities with complete constriction bands initially underwent z-plasty for band release, followed by manipulation and plaster casting. The other four extremities had incomplete bands, which were initially subjected to manipulation using the Ponseti method, followed by band release at the time of the Achilles tenotomy. Results: Over a mean follow-up time of 5 years, 7 of the study feet were plantigrade and painless, with no limitations of activities of daily living; only one foot showed limited dorsiflexion, and that patient is awaiting corrective surgery. This limb showed a double band in zone 2 that was both complete and deep. Conclusion: Despite the rigidity, clubfoot secondary to amniotic band constriction syndrome showed good outcomes when treated using the Ponseti method.

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Treatment of idiopathic clubfoot by Ponseti method: a prospective evaluation

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20172876 ◽

2017 ◽

Vol 3 (4) ◽

pp. 800

Author(s):

Vijaykumar Kulambi ◽

Subodh Shetty ◽

Venkatesh Ghantasala ◽

Vishwanath Bhagavati

Keyword(s):

Ponseti Method ◽

Congenital Deformity ◽

Idiopathic Clubfoot ◽

Pirani Score ◽

Significant Difference ◽

Before And After ◽

Plaster Casting ◽

Long Time ◽

Full Correction ◽

Pre Treatment

Background: From long time clubfoot has been a clinical challenge to orthopaedic surgeons. It is one of the commonest congenital deformity of the musculoskeletal system in children. Each year more than 1,00,000 babies are born with congenital clubfoot. 80% of which occur in developing countries.Methods: 60 feet in 40 children were treated by the Ponseti method from September 2014 to august 2016. Prospective follow up for a mean duration of 18 months was undertaken. The deformity was evaluated by Pirani score before and after the treatment. At the end of treatment all feet were functionally classified into good, fair and poor.Results: The average number of casts applied before full correction was 8. 21.66% of the feets needed tenotomy before full correction. 90% of the patients showed good results, 3.3% had fair results and 6.6% of patients had poor results. There was a significant difference in the pre-treatment and post-treatment pirani score values.Conclusions: Ponseti method of manipulation and plaster casting is very effective to correct club foot deformity.

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Casting with resins

The Paleontological Society Special Publications ◽

10.1017/s2475262200005293 ◽

1989 ◽

Vol 4 ◽

pp. 326-330

Author(s):

J. Smith ◽

B. Latimer

Keyword(s):

Plaster Casting ◽

Number Of Authors

Fossils are characteristically uncommon, making it impossible to distribute original specimens to all interested investigators. Dissemination of information, therefore, often depends upon the circulation of accurate reproductions. Such reproductions or casts can be made from a variety of materials including plasters and two-part resins. Using resins for the casting of paleontological specimens was discussed by a number of authors, including Burke and Jensen, 1961; Madsen, 1974; Parsons, 1973; Schrimper, 1973; Reser, 1981; and Burke et al., 1983 (see additional references in Hannibal, this volume, chapter 6). Plaster casting is covered by Babcock (this volume, chapter 34).

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