Hughes, K; Gelfer, Y; Cokljat, M; Wientroub, S; Yavor, A; Hemo, Y; Dunkley, M; Eastwood, DM
(2019)
Does idiopathic congenital talipes equinovarus have an impact on attainment of developmental milestones? A multicentre international study.
J Child Orthop, 13 (4).
pp. 353-360.
ISSN 1863-2521
https://doi.org/10.1302/1863-2548.13.190060
SGUL Authors: Gelfer, Yael
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Abstract
Purpose: The Ponseti method is a well-established approach to treating clubfoot. Potentially, both the underlying pathology and adherence to post-correction bracing can affect lower limb function and age of independent standing and walking. This cohort study investigates the age at which infants with idiopathic clubfoot treated using the Ponseti method achieved three selected developmental milestones and whether or not this correlated with treatment compliance. Methods: A prospectively collected database from four centres was visited. Inclusion criteria were patients with idiopathic clubfoot with no comorbidities or prior treatment. Age at attainment of independent standing, walking, nocturnal continence was compared across three groups: I) congenital talipes equinovarus (CTEV) children compliant with treatment; II) CTEV children non-compliant with treatment; and III) typically-developed siblings. Minimum follow-up was five years. Results: In all, 130 patients (198 feet) fitted the inclusion criteria: 43:87 (F:M). Standing was achieved by a mean 12.0 months in group I (sd 2.50); 12.0 months (sd 2.0) in II and ten months (sd 3.0) in III. Walking was achieved by a mean 15 months (sd 4.0) in group I, 14 months (sd 1.75) in II and 12 months (sd 3) in III, respectively. Both the compliant and non-compliant CTEV children were significantly slower at achieving standing and walking compared to sibling controls (p < 0.0001). There was no significant difference between age of nocturnal continence between the three groups. Conclusion: Infants with idiopathic clubfoot treated according to the Ponseti method achieve independent standing and walking approximately two months later than their typically-developed siblings. The delay is not related to the use of the foot abduction brace. Level of evidence: III.
Item Type: | Article |
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Additional Information: | This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed. |
Keywords: | Clubfoot, Ponseti, developmental milestones, Clubfoot, developmental milestones, Ponseti, 1114 Paediatrics And Reproductive Medicine, Orthopedics |
SGUL Research Institute / Research Centre: | Academic Structure > Institute of Medical, Biomedical and Allied Health Education (IMBE) |
Journal or Publication Title: | J Child Orthop |
ISSN: | 1863-2521 |
Language: | eng |
Publisher License: | Creative Commons: Attribution-Noncommercial 4.0 |
PubMed ID: | 31489040 |
Web of Science ID: | WOS:000481633900003 |
Go to PubMed abstract | |
URI: | https://openaccess.sgul.ac.uk/id/eprint/111248 |
Publisher's version: | https://doi.org/10.1302/1863-2548.13.190060 |
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