A Single-Center Evaluation of Mid-Term Results of Ponseti Management for Nonidiopathic Congenital Clubfeet in Vietnam

Nam Quang Dinh Vo; Giam Minh Trinh; Khang Trien Truong

doi:doi:10.11648/j.ajp.20200603.17

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A Single-Center Evaluation of Mid-Term Results of Ponseti Management for Nonidiopathic Congenital Clubfeet in Vietnam

Nam Quang Dinh Vo, Giam Minh Trinh, Khang Trien Truong

Published in American Journal of Pediatrics (Volume 6, Issue 3)

Received: 23 April 2020 Accepted: 18 May 2020 Published: 29 May 2020

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Abstract

By comparing initial correction, early relapses, latest follow-up mid-term results between idiopathic and nonidiopathic congenital clubfeet, this study is to define the efficacy of the Ponseti method for the nonidiopathic clubfeet. 32 nonidiopathic congenital clubfeet (group 1) in 21 children and 118 idiopathic congenital clubfeet (group 2) in 82 children (newborn to 12 months) are recruited for this study, following treatment with the Ponseti method with a follow-up period of a minimum of two years. The clubfeet are classified and evaluated during casting, of initial correction, and for early relapse according to Diméglio’s score. The latest follow-up results are evaluated according to Richards’ classification. The initial correction is successfully 81.3% in group 1, and 96.6% in group 2 (p=0.019). The early relapses are 26.9% in group 1, and 7.0% in group 2 (p=0.003); for group 1, 57.1% of early relapses were subjected to medial posterior release and for group 2, all of early relapses were successfully managed by casting (p < 0.001). The latest follow-up results are good 21.9%, fair 46.8%, poor 31.3% in group 1, and good 76.3%, fair 22.0%, poor 1.7% in group 2 (p < 0.001). This study indicates that the Ponseti method is successfully applied to nonidiopathic clubfeet. However, the early relapse rate of nonidiopathic clubfeet is high and most of these relapsing clubfeet need to be managed by posteromedial release. In addition, posteromedial release should be indicated as the initially definite management for very severe clubfeet of arthrogryposis.

Published in	American Journal of Pediatrics (Volume 6, Issue 3)
DOI	10.11648/j.ajp.20200603.17
Page(s)	218-222
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Idiopathic Congenital Clubfoot, Nonidiopathic Congenital Clubfoot, The Ponseti Method, Percutaneous Tendoachilles Tenotomy, Foot Abduction Brace

References

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[2]	Janicki JA, Narayanan UG, Harvey B, Roy A, Ramseier LE, Wright JG. Treatment of Neuromuscular and Syndrome-Associated (Nonidiopathic) Clubfeet Using the Ponseti method. J Pediatr Orthop 2009; 29: 393-397.
[3]	Funk J, Lebek S, Seidl T et al. Comparison of treatment results of idiopathic and non-idiopathic congenital clubfoot: Prospective evaluation of the Ponseti therapy. Orthopäde 2012; 41: 977.
[4]	Matar HE, Makki D, Garg NK. Treatment of syndrome-associated congenital talipes equinovarus using the Ponseti method: 4-12 years of follow-up. J Pediatr Orthop B 2018; 27: 56-60.
[5]	Matar HE, Beirne P, Garg NK. Effectiveness of the Ponseti method for treating clubfoot associated with myelomeningocele: 3-9 years follow-up. J Pediatr Orthop B 2017; 26: 133-136.
[6]	Abo El-Fadl S, Sallam A, Abdelbadie A. Early management of neurologic clubfoot using Ponseti casting with minor posterior release in myelomeningocele: a preliminary report. J Pediatr Orthop B 2016; 25: 105-107.
[7]	Bensahel H, Dimeglio A, Souchet P, et al. Final evaluation of clubfoot. J Pediatr Orthop B 1995; 4: 137–141.
[8]	Ponseti I, Morcuende JA, Mosca V, Pirani S, Dietz F, Herzenberg JE, et al. Clubfoot: Ponseti management. Seattle, WA, USA: Global-HELP Publication, 2005.
[9]	Vo QDN, Huynh MN. Mid-term results of Ponseti management for an idiopathic congenital clubfoot at a single center in Vietnam. J Pediatr Orthop B 2016; 25: 253–257.
[10]	Richards BS, Faulks S, Rathjen KE, Karol LA, Johnston CE, Jones SA. A comparison of two nonoperative methods of idiopathic clubfoot correction: the Ponseti method and the French functional (physiotherapy) method. J Bone Joint Surg Am 2008; 90: 2313–2321.
[11]	Gurnett CA, Boehm S, Connolly A, Reimschisel T, Dobbs MB. Impact of congenital talipes equinovarus etiology on treatment outcomes. Dev Med Child Neurol 2008; 50: 498-502.
[12]	Gerlach DJ, Gurnett CA, Limpaphayom N, Alaee F, Zhang Z, Porter K, Kirchhofer M, Smyth MD, Dobbs MB. Early Results of the Ponseti method for the Treatment of Clubfoot Associated with Myelomeningocele. J Bone Joint Surg Am 2009; 91: 1350–1359.
[13]	Richards BS, Faulks S. Clubfoot Infants Initially Thought to be Idiopathic, But Later Found Not to Be. How do They do With Nonoperative Treatment? J Pediatr Orthop 2019; 39: 42-45.
[14]	Dunkley M, Gelfer Y, Jackson D, Parnell E, Armstong J, Rafter C, Eastwood DM. Mid-term results of a physiotherapist-led Ponseti service for the management of non-idiopathic and idiopathic clubfoot. J Child Orthop 2015; 9: 183-189.
[15]	Gelfer Y, Dunkley M, Jackson D, Armstrong J, Rafter C, Parnell E, Eastwood DM. Evertor muscle activity as a predictor of the mid-term outcome following treatment of the idiopathic and non-idiopathic clubfoot. J Bone Joint Surg Br 2014; 96: 1264-8.
[16]	Boehm S, Limpaphayom N, Alaee F, Sinclair MF, Dobbs MB. Early Results of the Ponseti method for the Treatment of Clubfoot in Distal Arthrogryposis. J Bone Joint Surg Am 2008; 90: 1501-1507.
[17]	Vo QDN, Huynh MN, Phan VT. Early result of Ponseti management of congenital clubfoot. J Jpn Ped Orthop 2013; 22: 189–193.
[18]	Ponseti IV, Smoley EN. Congenital club foot: the results of treatment. J Bone Joint Surg Am 1963; 45: 261-275.
[19]	Zionts LE, Habell B. The Use of the Ponseti method to Treat Clubfeet Associated With Congenital Annular Band Syndrome. J Pediatr Orthop 2013; 33: 563-568.

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APA Style

Nam Quang Dinh Vo, Giam Minh Trinh, Khang Trien Truong. (2020). A Single-Center Evaluation of Mid-Term Results of Ponseti Management for Nonidiopathic Congenital Clubfeet in Vietnam. American Journal of Pediatrics, 6(3), 218-222. https://doi.org/10.11648/j.ajp.20200603.17

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ACS Style

Nam Quang Dinh Vo; Giam Minh Trinh; Khang Trien Truong. A Single-Center Evaluation of Mid-Term Results of Ponseti Management for Nonidiopathic Congenital Clubfeet in Vietnam. Am. J. Pediatr. 2020, 6(3), 218-222. doi: 10.11648/j.ajp.20200603.17

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AMA Style

Nam Quang Dinh Vo, Giam Minh Trinh, Khang Trien Truong. A Single-Center Evaluation of Mid-Term Results of Ponseti Management for Nonidiopathic Congenital Clubfeet in Vietnam. Am J Pediatr. 2020;6(3):218-222. doi: 10.11648/j.ajp.20200603.17

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@article{10.11648/j.ajp.20200603.17,
  author = {Nam Quang Dinh Vo and Giam Minh Trinh and Khang Trien Truong},
  title = {A Single-Center Evaluation of Mid-Term Results of Ponseti Management for Nonidiopathic Congenital Clubfeet in Vietnam},
  journal = {American Journal of Pediatrics},
  volume = {6},
  number = {3},
  pages = {218-222},
  doi = {10.11648/j.ajp.20200603.17},
  url = {https://doi.org/10.11648/j.ajp.20200603.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20200603.17},
  abstract = {By comparing initial correction, early relapses, latest follow-up mid-term results between idiopathic and nonidiopathic congenital clubfeet, this study is to define the efficacy of the Ponseti method for the nonidiopathic clubfeet. 32 nonidiopathic congenital clubfeet (group 1) in 21 children and 118 idiopathic congenital clubfeet (group 2) in 82 children (newborn to 12 months) are recruited for this study, following treatment with the Ponseti method with a follow-up period of a minimum of two years. The clubfeet are classified and evaluated during casting, of initial correction, and for early relapse according to Diméglio’s score. The latest follow-up results are evaluated according to Richards’ classification. The initial correction is successfully 81.3% in group 1, and 96.6% in group 2 (p=0.019). The early relapses are 26.9% in group 1, and 7.0% in group 2 (p=0.003); for group 1, 57.1% of early relapses were subjected to medial posterior release and for group 2, all of early relapses were successfully managed by casting (p < 0.001). The latest follow-up results are good 21.9%, fair 46.8%, poor 31.3% in group 1, and good 76.3%, fair 22.0%, poor 1.7% in group 2 (p < 0.001). This study indicates that the Ponseti method is successfully applied to nonidiopathic clubfeet. However, the early relapse rate of nonidiopathic clubfeet is high and most of these relapsing clubfeet need to be managed by posteromedial release. In addition, posteromedial release should be indicated as the initially definite management for very severe clubfeet of arthrogryposis.},
 year = {2020}
}

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TY  - JOUR
T1  - A Single-Center Evaluation of Mid-Term Results of Ponseti Management for Nonidiopathic Congenital Clubfeet in Vietnam
AU  - Nam Quang Dinh Vo
AU  - Giam Minh Trinh
AU  - Khang Trien Truong
Y1  - 2020/05/29
PY  - 2020
N1  - https://doi.org/10.11648/j.ajp.20200603.17
DO  - 10.11648/j.ajp.20200603.17
T2  - American Journal of Pediatrics
JF  - American Journal of Pediatrics
JO  - American Journal of Pediatrics
SP  - 218
EP  - 222
PB  - Science Publishing Group
SN  - 2472-0909
UR  - https://doi.org/10.11648/j.ajp.20200603.17
AB  - By comparing initial correction, early relapses, latest follow-up mid-term results between idiopathic and nonidiopathic congenital clubfeet, this study is to define the efficacy of the Ponseti method for the nonidiopathic clubfeet. 32 nonidiopathic congenital clubfeet (group 1) in 21 children and 118 idiopathic congenital clubfeet (group 2) in 82 children (newborn to 12 months) are recruited for this study, following treatment with the Ponseti method with a follow-up period of a minimum of two years. The clubfeet are classified and evaluated during casting, of initial correction, and for early relapse according to Diméglio’s score. The latest follow-up results are evaluated according to Richards’ classification. The initial correction is successfully 81.3% in group 1, and 96.6% in group 2 (p=0.019). The early relapses are 26.9% in group 1, and 7.0% in group 2 (p=0.003); for group 1, 57.1% of early relapses were subjected to medial posterior release and for group 2, all of early relapses were successfully managed by casting (p < 0.001). The latest follow-up results are good 21.9%, fair 46.8%, poor 31.3% in group 1, and good 76.3%, fair 22.0%, poor 1.7% in group 2 (p < 0.001). This study indicates that the Ponseti method is successfully applied to nonidiopathic clubfeet. However, the early relapse rate of nonidiopathic clubfeet is high and most of these relapsing clubfeet need to be managed by posteromedial release. In addition, posteromedial release should be indicated as the initially definite management for very severe clubfeet of arthrogryposis.
VL  - 6
IS  - 3
ER  -

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Author Information

Nam Quang Dinh Vo

Hospital for Traumatology and Orthopaedics, Hochiminh City, Vietnam
Giam Minh Trinh

Hospital for Traumatology and Orthopaedics, Hochiminh City, Vietnam
Khang Trien Truong

School of Medicine, Tan Tao University, Long An City, Vietnam

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APA Style

Nam Quang Dinh Vo, Giam Minh Trinh, Khang Trien Truong. (2020). A Single-Center Evaluation of Mid-Term Results of Ponseti Management for Nonidiopathic Congenital Clubfeet in Vietnam. American Journal of Pediatrics, 6(3), 218-222. https://doi.org/10.11648/j.ajp.20200603.17

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ACS Style

Nam Quang Dinh Vo; Giam Minh Trinh; Khang Trien Truong. A Single-Center Evaluation of Mid-Term Results of Ponseti Management for Nonidiopathic Congenital Clubfeet in Vietnam. Am. J. Pediatr. 2020, 6(3), 218-222. doi: 10.11648/j.ajp.20200603.17

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AMA Style

Nam Quang Dinh Vo, Giam Minh Trinh, Khang Trien Truong. A Single-Center Evaluation of Mid-Term Results of Ponseti Management for Nonidiopathic Congenital Clubfeet in Vietnam. Am J Pediatr. 2020;6(3):218-222. doi: 10.11648/j.ajp.20200603.17

Copy | Download

@article{10.11648/j.ajp.20200603.17,
  author = {Nam Quang Dinh Vo and Giam Minh Trinh and Khang Trien Truong},
  title = {A Single-Center Evaluation of Mid-Term Results of Ponseti Management for Nonidiopathic Congenital Clubfeet in Vietnam},
  journal = {American Journal of Pediatrics},
  volume = {6},
  number = {3},
  pages = {218-222},
  doi = {10.11648/j.ajp.20200603.17},
  url = {https://doi.org/10.11648/j.ajp.20200603.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20200603.17},
  abstract = {By comparing initial correction, early relapses, latest follow-up mid-term results between idiopathic and nonidiopathic congenital clubfeet, this study is to define the efficacy of the Ponseti method for the nonidiopathic clubfeet. 32 nonidiopathic congenital clubfeet (group 1) in 21 children and 118 idiopathic congenital clubfeet (group 2) in 82 children (newborn to 12 months) are recruited for this study, following treatment with the Ponseti method with a follow-up period of a minimum of two years. The clubfeet are classified and evaluated during casting, of initial correction, and for early relapse according to Diméglio’s score. The latest follow-up results are evaluated according to Richards’ classification. The initial correction is successfully 81.3% in group 1, and 96.6% in group 2 (p=0.019). The early relapses are 26.9% in group 1, and 7.0% in group 2 (p=0.003); for group 1, 57.1% of early relapses were subjected to medial posterior release and for group 2, all of early relapses were successfully managed by casting (p < 0.001). The latest follow-up results are good 21.9%, fair 46.8%, poor 31.3% in group 1, and good 76.3%, fair 22.0%, poor 1.7% in group 2 (p < 0.001). This study indicates that the Ponseti method is successfully applied to nonidiopathic clubfeet. However, the early relapse rate of nonidiopathic clubfeet is high and most of these relapsing clubfeet need to be managed by posteromedial release. In addition, posteromedial release should be indicated as the initially definite management for very severe clubfeet of arthrogryposis.},
 year = {2020}
}

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TY  - JOUR
T1  - A Single-Center Evaluation of Mid-Term Results of Ponseti Management for Nonidiopathic Congenital Clubfeet in Vietnam
AU  - Nam Quang Dinh Vo
AU  - Giam Minh Trinh
AU  - Khang Trien Truong
Y1  - 2020/05/29
PY  - 2020
N1  - https://doi.org/10.11648/j.ajp.20200603.17
DO  - 10.11648/j.ajp.20200603.17
T2  - American Journal of Pediatrics
JF  - American Journal of Pediatrics
JO  - American Journal of Pediatrics
SP  - 218
EP  - 222
PB  - Science Publishing Group
SN  - 2472-0909
UR  - https://doi.org/10.11648/j.ajp.20200603.17
AB  - By comparing initial correction, early relapses, latest follow-up mid-term results between idiopathic and nonidiopathic congenital clubfeet, this study is to define the efficacy of the Ponseti method for the nonidiopathic clubfeet. 32 nonidiopathic congenital clubfeet (group 1) in 21 children and 118 idiopathic congenital clubfeet (group 2) in 82 children (newborn to 12 months) are recruited for this study, following treatment with the Ponseti method with a follow-up period of a minimum of two years. The clubfeet are classified and evaluated during casting, of initial correction, and for early relapse according to Diméglio’s score. The latest follow-up results are evaluated according to Richards’ classification. The initial correction is successfully 81.3% in group 1, and 96.6% in group 2 (p=0.019). The early relapses are 26.9% in group 1, and 7.0% in group 2 (p=0.003); for group 1, 57.1% of early relapses were subjected to medial posterior release and for group 2, all of early relapses were successfully managed by casting (p < 0.001). The latest follow-up results are good 21.9%, fair 46.8%, poor 31.3% in group 1, and good 76.3%, fair 22.0%, poor 1.7% in group 2 (p < 0.001). This study indicates that the Ponseti method is successfully applied to nonidiopathic clubfeet. However, the early relapse rate of nonidiopathic clubfeet is high and most of these relapsing clubfeet need to be managed by posteromedial release. In addition, posteromedial release should be indicated as the initially definite management for very severe clubfeet of arthrogryposis.
VL  - 6
IS  - 3
ER  -

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