Treatment of idiopathic club foot after the walking age: a systematic review.
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Published:
Feb 12, 2017
Keywords:
club foot, Ponseti, children, gait age
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Abstract
IntroductionPonseti´s Method efficacy in newborns have led to widen the indications in older patients. A systematic review of the literature was performed to: 1) Define the degree of scientific evidence of Ponseti´s method in children over 1 year-old with clubfoot; 2) Assess the number of casts and associated procedures required to accomplish full correction; 3) Determine the percentage of full corrected patients; and, 4) Identify the rate of recurrence and complications related to this method Methods Any paper referred to Ponseti´s Method after walking age was selected using PubMed, Ovid and Cochrane as our databases. Our Inclusion criteria were papers with patients over a year old, with > 1 year follow-up, more than 5 patients, published until May 1st 2014. Papers selected should mention correction rate, complications, cast number, and associated procedures required to achieve full correction. Results Eleven papers met the inclusion criteria. The sample consisted in 449 patients. The average age at the beginning of treatment was 3.8 years (range 1 to 18).The average follow up was 31 months. An average of 8 (4-12) casts was required to accomplish full correction. Plantigrade feet were achieved in 75%. Eighteen out of 417 feet presented minor complications (4.3%), without impact on the final result. DiscussionCurrent evidence regarding Ponseti’s method for patients over 1 year-old is primarily Level IV. Eventhough requires higher number of casts and associated procedures; deformity correction is safely achieved in most patients.
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Porta, J., & Masquijo, J. J. (2017). Treatment of idiopathic club foot after the walking age: a systematic review. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 82(1), 14-18. https://doi.org/10.15417/625
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Clinical Research
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References
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2. Van Gelder JH, Van Ruiten AG, Visser JD, Maathuis PG. Long-term results of the posteromedial release in the treatment of idiopathic clubfoot. J Pediatr Orthop. 2010 Oct-Nov;30(7):700-4.
3. Dobbs MB, Nunley R, Schoenecker PL. Long-term follow-up of patients with clubfeet treated with extensive soft-tissue release. J Bone Joint Surg Am. 2006 May;88(5):986-96.
4. Laaveg SJ, Ponseti IV. Long-term results of treatment of congenital club foot. J Bone Joint Surg Am 1980;62-A:23-31.
5. Ponseti IV. Congenital clubfoot. Fundamentals for treatment. Oxford: Oxford University Press; 1996.
6. Lourenço AF, Morcuende JA. Correction of neglected idiopathic club foot by the Ponseti method. J Bone Joint Surg Br. 2007 Mar;89(3):378-81.
7. Gul A, Sambanandam. Results of manipulation of idiopathic clubfoot deformity in Malawi by orthopedic clinical offers using the Ponseti Method: a realistic alternative for the developing world? J Pediatr Orthop. 2007 Dec;27(8):971;
8. Gargs S. Use of Ponseti method for recurrent clubfoot following posteromedial reléase. Indian Orthop. 2008. Jan;42(1):68-72.
9. Spiegel DA, Shrestha OP, Sitoula P, Rajbhandary T, Bijukachhe B, Banskota AK. Ponseti method for untreated idiopathic clubfeet in Nepalese patients from 1 to 6 years of age. Clin Orthop Relat Res. 2009 May;467(5):1164-70.
10. Yagmurlu MF, Ermis MN, Akdeniz HE, Kesin E, Karakas ES. Ponseti management of clubfoot after walking age. Pediatr Int. 2011 Feb;53(1):85-9.
11. Adeghehingbe, Oginni. Ponseti clubfoot management: changing surgical trends in Nigeria. Iowa Orthop. 2010 30:7-14.
12. Verma A, Mehtani A, Sural S, Maini L, Gautam VK, Basran SS, Arora S. Management of idiopathic clubfoot in toddlers by Ponseti's method. J Pediatr Orthop B. 2012 Jan;21(1):79-84.
13. Alves C, Escalda C, Fernandes P, Tavares D, Neves MC. Ponseti method: does age at the beginning of treatment make a difference?. Clin Orthop Relat Res. 2009 2009 May;467(5):1271-7.
14. Ayana B, Klungsøyr PJ. Good results after Ponseti treatment for neglected congenital clubfoot in Ethiopia. A prospective study of 22 children (32 feet) from 2 to 10 years of age. Acta Orthop. 2014 Dec;85(6):641-5. doi: 10.3109/17453674.2014.957085. Epub 2014 Sep 1.
15. Faizan M, Jilani LZ, Abbas M, Zahid M, Asif N. Management of Idiopathic Clubfoot by Ponseti Technique in Children Presenting After One Year of Age. J Foot Ankle Surg. 2014 Sep-Oct;54(5):967-72.
16. Khan SA , Kumar A. Ponseti´s manipulation in neglected clubfoot in children more than 7 years of age: a prospective evaluation of 25 feet with long-term follow up. J Pediatr Orthop B 2010 Sep:19(5):385-9.
17. Banskota B, Banskota AK. The Ponseti method in the treatment of children with idiopatic clubfoot presenting between five and ten years of age. Bone Joint J 2013 Dec;95-B(12):1721-5.
18. Agarwal A. Does initial Pirani score and age influence the number of Ponseti cast in children? Int Orthop 2014 Oct;38(10):2221.
19. Ford-Powell VA1, Barker S, Khan MS, Evans AM, Deitz FR. The Bangladesh clubfoot project: the first 5000 feet. J Pediatr Orthop. 2013 Jun;33(4):e40-4.
20. Wang YZ, Wang XW, Zhang P, Wang XS. Application of Ponseti method in patients older than 6 months with congenital talipes equinovarus. Beijing Da Xue Xue Bao. 2009 Aug 18;41(4):452-5.
21. Ponseti IV. Relapsing clubfoot: causes, prevention, and treatment. Iowa Orthop J. 2002;22:55-6.
22. Dobbs MB, Corley CL, Morcuende JA, Ponseti IV. Late recurrence of clubfoot deformity: a 45-year followup. Clin Orthop Relat Res. 2003 Jun;(411):188-92.
23. Gupta A. Evaluation of the utility of the Ponseti Method of correction of clubfoot deformity in a developing nation. Int Orthop 2008 Feb;32(1):75-9.
24. Morcuende JA. Management of congenital talipes equinovarus using the Ponseti method: a systematic review. J Bone Joint Surg Br. 2011 Sep;93(9):1160-4.
25. Horn BD, Davidson RS. Current treatment of clubfoot in infancy and childhood. Foot Ankle Clin. 2010 Jun;15(2):235-43.
26. Ponseti IV. Long-term results of treatment of congenital club foot. J Bone Joint Surg Am. 1980 Jan;62(1):23-31.
27. Masquijo J, Marchegiani S, Allende V. Diagnóstico prenatal del pie bot. Rev. argent. radiol. [online]. 2011, vol.75, n.4, pp. 335-339.
28. Derzsi Z, Gozar H, Gurzu S, Prisca R, Nagy OJ. Congenital clubfoot in children after walking age: management and evaluation of 41 feet with the dimeglio score. Clin Diagn Res. 2013 Dec;7(12):2841-3.
29. López Lobato R, Downey Carmona FJ, Farrington Rueda, DM. Complicaciones del método Ponseti: Edema de miembro por efecto ventana. Rev. Soc. Andal. Traumatol. Ortop. 2014; 31(2): 73-76.
30. Halanski M A. Ponseti Method Compared with Surgical Treatment of Clubfoot. A Prospective Comparison. J Bone Joint Surg Am 2010; 92(2): 270-277.
2. Van Gelder JH, Van Ruiten AG, Visser JD, Maathuis PG. Long-term results of the posteromedial release in the treatment of idiopathic clubfoot. J Pediatr Orthop. 2010 Oct-Nov;30(7):700-4.
3. Dobbs MB, Nunley R, Schoenecker PL. Long-term follow-up of patients with clubfeet treated with extensive soft-tissue release. J Bone Joint Surg Am. 2006 May;88(5):986-96.
4. Laaveg SJ, Ponseti IV. Long-term results of treatment of congenital club foot. J Bone Joint Surg Am 1980;62-A:23-31.
5. Ponseti IV. Congenital clubfoot. Fundamentals for treatment. Oxford: Oxford University Press; 1996.
6. Lourenço AF, Morcuende JA. Correction of neglected idiopathic club foot by the Ponseti method. J Bone Joint Surg Br. 2007 Mar;89(3):378-81.
7. Gul A, Sambanandam. Results of manipulation of idiopathic clubfoot deformity in Malawi by orthopedic clinical offers using the Ponseti Method: a realistic alternative for the developing world? J Pediatr Orthop. 2007 Dec;27(8):971;
8. Gargs S. Use of Ponseti method for recurrent clubfoot following posteromedial reléase. Indian Orthop. 2008. Jan;42(1):68-72.
9. Spiegel DA, Shrestha OP, Sitoula P, Rajbhandary T, Bijukachhe B, Banskota AK. Ponseti method for untreated idiopathic clubfeet in Nepalese patients from 1 to 6 years of age. Clin Orthop Relat Res. 2009 May;467(5):1164-70.
10. Yagmurlu MF, Ermis MN, Akdeniz HE, Kesin E, Karakas ES. Ponseti management of clubfoot after walking age. Pediatr Int. 2011 Feb;53(1):85-9.
11. Adeghehingbe, Oginni. Ponseti clubfoot management: changing surgical trends in Nigeria. Iowa Orthop. 2010 30:7-14.
12. Verma A, Mehtani A, Sural S, Maini L, Gautam VK, Basran SS, Arora S. Management of idiopathic clubfoot in toddlers by Ponseti's method. J Pediatr Orthop B. 2012 Jan;21(1):79-84.
13. Alves C, Escalda C, Fernandes P, Tavares D, Neves MC. Ponseti method: does age at the beginning of treatment make a difference?. Clin Orthop Relat Res. 2009 2009 May;467(5):1271-7.
14. Ayana B, Klungsøyr PJ. Good results after Ponseti treatment for neglected congenital clubfoot in Ethiopia. A prospective study of 22 children (32 feet) from 2 to 10 years of age. Acta Orthop. 2014 Dec;85(6):641-5. doi: 10.3109/17453674.2014.957085. Epub 2014 Sep 1.
15. Faizan M, Jilani LZ, Abbas M, Zahid M, Asif N. Management of Idiopathic Clubfoot by Ponseti Technique in Children Presenting After One Year of Age. J Foot Ankle Surg. 2014 Sep-Oct;54(5):967-72.
16. Khan SA , Kumar A. Ponseti´s manipulation in neglected clubfoot in children more than 7 years of age: a prospective evaluation of 25 feet with long-term follow up. J Pediatr Orthop B 2010 Sep:19(5):385-9.
17. Banskota B, Banskota AK. The Ponseti method in the treatment of children with idiopatic clubfoot presenting between five and ten years of age. Bone Joint J 2013 Dec;95-B(12):1721-5.
18. Agarwal A. Does initial Pirani score and age influence the number of Ponseti cast in children? Int Orthop 2014 Oct;38(10):2221.
19. Ford-Powell VA1, Barker S, Khan MS, Evans AM, Deitz FR. The Bangladesh clubfoot project: the first 5000 feet. J Pediatr Orthop. 2013 Jun;33(4):e40-4.
20. Wang YZ, Wang XW, Zhang P, Wang XS. Application of Ponseti method in patients older than 6 months with congenital talipes equinovarus. Beijing Da Xue Xue Bao. 2009 Aug 18;41(4):452-5.
21. Ponseti IV. Relapsing clubfoot: causes, prevention, and treatment. Iowa Orthop J. 2002;22:55-6.
22. Dobbs MB, Corley CL, Morcuende JA, Ponseti IV. Late recurrence of clubfoot deformity: a 45-year followup. Clin Orthop Relat Res. 2003 Jun;(411):188-92.
23. Gupta A. Evaluation of the utility of the Ponseti Method of correction of clubfoot deformity in a developing nation. Int Orthop 2008 Feb;32(1):75-9.
24. Morcuende JA. Management of congenital talipes equinovarus using the Ponseti method: a systematic review. J Bone Joint Surg Br. 2011 Sep;93(9):1160-4.
25. Horn BD, Davidson RS. Current treatment of clubfoot in infancy and childhood. Foot Ankle Clin. 2010 Jun;15(2):235-43.
26. Ponseti IV. Long-term results of treatment of congenital club foot. J Bone Joint Surg Am. 1980 Jan;62(1):23-31.
27. Masquijo J, Marchegiani S, Allende V. Diagnóstico prenatal del pie bot. Rev. argent. radiol. [online]. 2011, vol.75, n.4, pp. 335-339.
28. Derzsi Z, Gozar H, Gurzu S, Prisca R, Nagy OJ. Congenital clubfoot in children after walking age: management and evaluation of 41 feet with the dimeglio score. Clin Diagn Res. 2013 Dec;7(12):2841-3.
29. López Lobato R, Downey Carmona FJ, Farrington Rueda, DM. Complicaciones del método Ponseti: Edema de miembro por efecto ventana. Rev. Soc. Andal. Traumatol. Ortop. 2014; 31(2): 73-76.
30. Halanski M A. Ponseti Method Compared with Surgical Treatment of Clubfoot. A Prospective Comparison. J Bone Joint Surg Am 2010; 92(2): 270-277.