Treatment of non-idiopathic clubfeet with the Ponseti method: a systematic review
| Autor: | Sandra Prinsen, T. De Mulder, A. Van Campenhout |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Arthrogryposis
030222 orthopedics Pediatrics medicine.medical_specialty business.industry Spina bifida Treatment method medicine.disease Ponseti method arthrogryposis spina bifida 03 medical and health sciences 0302 clinical medicine Pediatrics Perinatology and Child Health non-idiopathic clubfeet Medicine Orthopedics and Sports Medicine 030212 general & internal medicine Systematic Review medicine.symptom business |
| Zdroj: | Journal of Children's Orthopaedics |
| ISSN: | 1863-2548 1863-2521 |
| Popis: | Purpose Although non-idiopathic clubfeet were long thought to be resistant to non-surgical treatment methods, more studies documenting results on treatment of these feet with the Ponseti method are being published. The goal of this systematic review is to summarize current evidence on treatment of non-idiopathic clubfeet using the Ponseti method. Methods PubMed and Limo were searched, reference lists of eligible studies were screened and studies that met the inclusion criteria were included. Data on average number of casts, Achilles tendon tenotomy (ATT), initial correction, recurrence, successful treatment at final follow-up and complications were pooled. The Methodological Index for Non-Randomized Studies was used to assess the methodological quality of the selected studies. Results In all, 11 studies were included, yielding a total of 374 non-idiopathic and 801 idiopathic clubfeet. Non-idiopathic clubfeet required more casts (7.2 versus 5.4) and had a higher rate of ATT (89.4% versus 75.7%). Furthermore, these feet had a higher recurrence rate (43.3% versus 11.5%) and a lower rate of successful treatment at final follow-up (69.3% versus 95.0%). Complications were found in 20.3% of the non-idiopathic cohort. When comparing results between clubfeet associated with myelomeningocele and arthrogryposis, the first group presented with a lower number of casts (5.4 versus 7.2) and a higher rate of successful treatment at final follow-up (81.8% versus 58.2%). Conclusion The Ponseti method is a valuable and non-invasive option in the primary treatment of non-idiopathic clubfeet in young children. Studies with longer follow-up are necessary to evaluate its long-term effect. Level of Evidence Level III – systematic review of Level-III studies. This work meets the requirements of the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). |
| Databáze: | OpenAIRE |
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