Document Detail


An accelerated Ponseti versus the standard Ponseti method: a prospective randomised controlled trial.
MedLine Citation:
PMID:  21357965     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We conducted a prospective randomised controlled trial to compare the standard Ponseti plaster method with an accelerated method for the treatment of idiopathic congenital talipes equinovarus. The standard weekly plaster-change method was accelerated to three times per week. We hypothesised that both methods would be equally effective in achieving correction. A total of 40 consecutive patients (61 feet) were entered into the trial. The initial median Pirani score was 5.5 (95% confidence interval 4.5 to 6.0) in the accelerated group and 5.0 (95% confidence interval 4.0 to 5.0) in the standard control group. The scores decreased by an average 4.5 in the accelerated group and 4.0 in the control group. There was no significant difference in the final Pirani score between the two groups (chi-squared test, p = 0.308). The median number of treatment days in plaster was 16 in the accelerated group and 42 in the control group (p < 0.001). Of the 19 patients in the accelerated group, three required plaster treatment for more than 21 days and were then assigned to the standard control method. Of the 40 patients, 36 were followed for a minimum of six months. These results suggest that comparable outcomes can be achieved with an accelerated Ponseti method. The ability to complete all necessary manipulations within a three-week period facilitates treatment where patients have to travel long distances.
Authors:
P Harnett; R Freeman; W J Harrison; L C Brown; V Beckles
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of bone and joint surgery. British volume     Volume:  93     ISSN:  0301-620X     ISO Abbreviation:  J Bone Joint Surg Br     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-01     Completed Date:  2011-04-28     Revised Date:  2013-06-24    
Medline Journal Info:
Nlm Unique ID:  0375355     Medline TA:  J Bone Joint Surg Br     Country:  England    
Other Details:
Languages:  eng     Pagination:  404-8     Citation Subset:  AIM; IM    
Affiliation:
Beit-Cure International Hospital, PO Box 31236, Blantyre 3, Malawi. paulharnett2@yahoo.co.uk
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MeSH Terms
Descriptor/Qualifier:
Casts, Surgical*
Clubfoot / surgery*
Female
Follow-Up Studies
Humans
Infant
Infant, Newborn
Male
Orthopedic Procedures / methods*
Prospective Studies
Recurrence
Time Factors
Treatment Outcome
Comments/Corrections
Comment In:
Orthopade. 2013 May;42(5):371-2   [PMID:  23657906 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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