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Ponseti Method: Does Age at the Beginning of Treatment Make a Difference?

  • Symposium: Clubfoot: Etiology and Treatment
  • Published:
Clinical Orthopaedics and Related Research

Abstract

The Ponseti method is reportedly effective for treating clubfoot in children up to 9 years of age. However, whether age at the beginning of treatment influences the rate of successful correction and the rate of relapse is unknown. We therefore retrospectively reviewed 68 consecutive children with 102 idiopathic clubfeet treated by the Ponseti technique in four Portuguese hospitals. We followed patients a minimum of 30 months (mean, 41.4 months; range, 30–61 months). The patients were divided into two groups according to their age at the beginning of treatment; Group I was younger than 6 months and Group II was older than 6 months. All feet (100%) were initially corrected and no feet required extensive surgery regardless of age at the beginning of treatment. There were no differences between Groups I and II in the number of casts, tenotomies, success in terms of rate of initial correction, rate of recurrence, and rate of tibialis anterior transference. The rate of the Ponseti method in avoiding extensive surgery was 100% in Groups I and II; relapses occurred in 8% of the feet in younger and older children.

Level of Evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Luis Filipe Costa Neves, MD, for his support and advice. We also thank Monica Thuesing, MD, and Filipa Monarca, MD, for their help in collecting data for this study.

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Hospital Central do Funchal, Av Luis Camões, 9000-514, Funchal, Portugal

    Cristina Alves MD, FEBOT

  2. Hospital Garcia d’Orta, Almada, Portugal

    Carolina Escalda MD

  3. Hospital de Santa Maria, Lisboa, Portugal

    Pedro Fernandes MD, FEBOT

  4. Hospital Dona Estefânia, Lisboa, Portugal

    Delfin Tavares MD & M. Cassiano Neves MD

Authors
  1. Cristina Alves MD, FEBOT
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  2. Carolina Escalda MD
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  3. Pedro Fernandes MD, FEBOT
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  4. Delfin Tavares MD
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  5. M. Cassiano Neves MD
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Corresponding author

Correspondence to Cristina Alves MD, FEBOT.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research and that informed consent was obtained.

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Alves, C., Escalda, C., Fernandes, P. et al. Ponseti Method: Does Age at the Beginning of Treatment Make a Difference?. Clin Orthop Relat Res 467, 1271–1277 (2009). https://doi.org/10.1007/s11999-008-0698-1

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  • DOI: https://doi.org/10.1007/s11999-008-0698-1

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