Current Concepts on Bracing in the Ponseti Method
Abstract
The Ponseti method has become the gold standard for the treatment of clubfoot, with excellent long-term functional outcomes. Adherence to the bracing protocol is essential for the long-term success of the treatment. Currently, there are multiple braces that can be used to prevent relapse. In this article, we provide a review of clubfoot braces, discussing their advantages and disadvantages, as well as the current evidence on each of them.Downloads
References
Rastogi A, Agarwal A. Long-term outcomes of the Ponseti method for treatment of clubfoot: a systematic review. Int Orthop 2021;45(10):2599-608. https://doi.org/10.1007/s00264-021-05189-w
Ponseti IV. Congenital clubfoot. Fundamentals of treatment. New York: Oxford University Press; 1996.
Ponseti IV, Smoley EN. Congenital clubfoot: the results of treatment. J Bone Joint Surg Am 1963;45:261-75. Disponible en: https://jbjs.org/reader.phprsuite_id=313121&native=1&source=The_Journal_of_Bone_and_Joint_ Surgery/45/2/261/fulltext&topics=fa%2Bpd#info
Morcuende JA, Dolan LA, Dietz FR, Ponseti IV. Radical reduction in the rate of extensive corrective surgery for clubfoot using the Ponseti method. Pediatrics 2004;113(2):376-80. https://doi.org/10.1542/peds.113.2.376
Desai L, Oprescu F, DiMeo A, Morcuende JA. Bracing in the treatment of children with clubfoot: past, present, and future. Iowa Orthop J 2010;30:15-23. PMID: 21045966
Dobbs MB, Rudzki JR, Purcell DB, Walton T, Porter KR, Gurnett CA. Factors predictive of outcome after use of the Ponseti method for the treatment of idiopathic clubfeet. J Bone Joint Surg Am 2004;86(1):22-7.
https://doi.org/10.2106/00004623-200401000-00005
Dobbs MB, Corley CL, Morcuende JA, Ponseti IV. Late recurrence of clubfoot deformity: a 45-year followup. Clin Orthop Relat Res 2003;(411):188-92. https://doi.org/10.1097/01.blo.0000065837.77325.19
George HL, Unnikrishnan PN, Garg NK, Sampath J, Bruce CE. Unilateral foot abduction orthosis: is it a substitute for Denis Browne boots following Ponseti technique? J Pediatr Orthop B 2011;20(1):22-5.
https://doi.org/10.1097/BPB.0b013e32833fb8a5
Browne D. Talipes equino varus. Postgrad Med J 1937;13(144):349-362.1. https://doi.org/10.1136/pgmj.13.144.349
Bouchoucha S, Smida M, Saïed W, Safi H, Ammar C, Nessib MN, et al. Early results of the Ponseti method using the Steenbek foot abduction brace: a prospective study of 95 feet. J Pediatr Orthop B 2008;17(3):134-8. https://doi.org/10.1097/BPB.0b013e3282fa5f0d
Gupta A, Singh S, Patel P, Patel J, Varshney MK. Evaluation of the utility of the Ponseti method of correction of clubfoot deformity in a developing nation. Int Orthop 2008;32(1):75-9. https://doi.org/10.1007/s00264-006-0284-7
Zionts LE, Frost N, Kim R, Ebramzadeh E, Sangiorgio SN. Treatment of idiopathic clubfoot: experience with the Mitchell-Ponseti brace. J Pediatr Orthop 2012;32(7):706-13. https://doi.org/10.1097/BPO.0b013e3182694f4d
Chen RC, Gordon JE, Luhmann SJ, Schoenecker PL, Dobbs MB. A new dynamic foot abduction orthosis for clubfoot treatment. J Pediatr Orthop 2007;27(5):522-8. https://doi.org/10.1097/bpo.0b013e318070cc19
Garg S, Porter K. Improved bracing compliance in children with clubfeet using a dynamic orthosis. J Child Orthop 2009;3(4):271-6. https://doi.org/10.1007/s11832-009-0182-9
Savonen B, Gershenson J, Bow JK, Pearce J. Open-source three-dimensional printable infant clubfoot brace. Journal of Prosthetics and Orthotics 2019;32(2):149-58. https://doi.org/10.1097/JPO.0000000000000257
Janicki JA, Wright JG, Weir S, Narayanan UG. A comparison of ankle foot orthoses with foot abduction orthoses to prevent recurrence following correction of idiopathic clubfoot by the Ponseti method. J Bone Joint Surg Br 2011;93(5):700-4. https://doi.org/10.1302/0301-620X.93B5.24883
Sætersdal C, Fevang JM, Engesæter LB. Inferior results with unilateral compared with bilateral brace in Ponsetitreated clubfeet. J Child Orthop 2017;11(3):216-22. https://doi.org/10.1302/1863-2548.11.160279
Mahan ST, May CJ, Kasser JR. Early experience with the C-PRO ADM brace in clubfoot. J Orthop Res Ther 2020;5:1164. https://doi.org/10.29011/2575- 8241.001164
Rahman T, Borkhuu B, Littleton AG, Sample W, Moran E, Campbell S, et al. Electronic monitoring of scoliosis brace wear compliance. J Child Orthop 2010;4(4):343-7. https://doi.org/10.1007/s11832-010-0266-6
Rahman T, Sample W, Yorgova P, Neiss G, Rogers K, Shah S, et al. Electronic monitoring of orthopedic brace compliance. J Child Orthop 2015;9(5):365-9. https://doi.org/10.1007/s11832-015-0679-3
Fuss FK, Ahmad A, Tan AM, Razman R, Weizman Y. Pressure sensor system for customized scoliosis braces. Sensors (Basel) 2021;21(4):1153. https://doi.org/10.3390/s21041153
Morgenstein A, Davis R, Talwalkar V, Iwinski H Jr, Walker J, Milbrandt TA. A randomized clinical trial
comparing reported and measured wear rates in clubfoot bracing using a novel pressure sensor. J Pediatr Orthop 2015;35(2):185-91. https://doi.org/10.1097/BPO.0000000000000205
Sangiorgio SN, Ho NC, Morgan RD, Ebramzadeh E, Zionts LE. The objective measurement of brace-use adherence in the treatment of idiopathic clubfoot. J Bone Joint Surg Am 2016;98(19):1598-1605.
https://doi.org/10.2106/JBJS.16.00170
Richards BS, Faulks S, Felton K, Karacz CM. Objective measurement of brace wear in successfully Ponseti-treated clubfeet: Pattern of decreasing use in the first 2 years. J Am Acad Orthop Surg 2020;28(9):383-7. https://doi.org/10.5435/JAAOS-D-19-00163
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