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Comparison of serial casting and stretching technique in children with congenital idiopathic clubfoot: Evaluation of a new assessment system.

Andriesse, Hanneke LU and Hägglund, Gunnar LU (2008) In Acta Orthopaedica 79(1). p.53-61
Abstract
Background and purpose The outcome of clubfoot treatment is the result of several factors such as severity, type of treatment, and measurement instruments. We compared two intervention groups with two assessment procedures. Patients and methods 16 children were treated consecutively with intensive stretching according to the Copenhagen method and 16 children consecutively with casting according to the Ponseti technique, during their first 2 months of age. The need for surgery was then assessed. At 4 months of age, all children used a dynamic Knee Ankle Foot Orthosis. The Clubfoot Assessment Protocol (CAP) and the Dimeglio Classification System (DCS) were used and compared during treatment and at 2 years of age. Results According to the CAP... (More)
Background and purpose The outcome of clubfoot treatment is the result of several factors such as severity, type of treatment, and measurement instruments. We compared two intervention groups with two assessment procedures. Patients and methods 16 children were treated consecutively with intensive stretching according to the Copenhagen method and 16 children consecutively with casting according to the Ponseti technique, during their first 2 months of age. The need for surgery was then assessed. At 4 months of age, all children used a dynamic Knee Ankle Foot Orthosis. The Clubfoot Assessment Protocol (CAP) and the Dimeglio Classification System (DCS) were used and compared during treatment and at 2 years of age. Results According to the CAP (but not the DCS) the casting technique was superior in clubfoot correction, apparent as better mobility and better quality of motion at 2 years of age. These children also required less surgery. The orthotics management functioned well in both groups, with high compliance and maintenance or slight improvement of the clinical status except for morphology. DCS score changed over time but not between the groups. Because of its multidimensional and narrower scoring interval construct, the CAP enabled us to elucidate and evaluate different clinical functions. Interpretation The casting technique according to Ponseti seems to be the better of the two for clubfoot correction, regarding mobility and quality of motion. The Clubfoot Assessment Protocol (but not the Dimeglio Classification System) was able to reveal differences between the Copenhagen and Ponseti treatment methods. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Orthopaedica
volume
79
issue
1
pages
53 - 61
publisher
Taylor & Francis
external identifiers
  • PMID:18283573
  • WOS:000253335400009
  • Scopus:39449106709
ISSN
1745-3682
DOI
10.1080/17453670710014761
language
English
LU publication?
yes
id
ba37c500-6961-4778-9ab4-dd466c7f1b91 (old id 1041757)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18283573?dopt=Abstract
date added to LUP
2008-03-03 11:51:50
date last changed
2017-02-12 04:20:47
@article{ba37c500-6961-4778-9ab4-dd466c7f1b91,
  abstract     = {Background and purpose The outcome of clubfoot treatment is the result of several factors such as severity, type of treatment, and measurement instruments. We compared two intervention groups with two assessment procedures. Patients and methods 16 children were treated consecutively with intensive stretching according to the Copenhagen method and 16 children consecutively with casting according to the Ponseti technique, during their first 2 months of age. The need for surgery was then assessed. At 4 months of age, all children used a dynamic Knee Ankle Foot Orthosis. The Clubfoot Assessment Protocol (CAP) and the Dimeglio Classification System (DCS) were used and compared during treatment and at 2 years of age. Results According to the CAP (but not the DCS) the casting technique was superior in clubfoot correction, apparent as better mobility and better quality of motion at 2 years of age. These children also required less surgery. The orthotics management functioned well in both groups, with high compliance and maintenance or slight improvement of the clinical status except for morphology. DCS score changed over time but not between the groups. Because of its multidimensional and narrower scoring interval construct, the CAP enabled us to elucidate and evaluate different clinical functions. Interpretation The casting technique according to Ponseti seems to be the better of the two for clubfoot correction, regarding mobility and quality of motion. The Clubfoot Assessment Protocol (but not the Dimeglio Classification System) was able to reveal differences between the Copenhagen and Ponseti treatment methods.},
  author       = {Andriesse, Hanneke and Hägglund, Gunnar},
  issn         = {1745-3682},
  language     = {eng},
  number       = {1},
  pages        = {53--61},
  publisher    = {Taylor & Francis},
  series       = {Acta Orthopaedica},
  title        = {Comparison of serial casting and stretching technique in children with congenital idiopathic clubfoot: Evaluation of a new assessment system.},
  url          = {http://dx.doi.org/10.1080/17453670710014761},
  volume       = {79},
  year         = {2008},
}