Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Floh, U.
Comparison of long term outcome of Ponseti versus surgical treatment for idiopathic clubfoot
Humanmedizin; [ Diplomarbeit ] Medical University of Graz; 2014. pp. 62
[OPEN ACCESS]
FullText
- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Steinwender Gerhardt
- Svehlik Martin
- Altmetrics:
- Abstract:
- Finding the right course of treatment in order to assure best quality of life for affected children is an essential aim in children´s orthopedics. Clubfoot is a rather common deformity in newborn. There is still a lack of randomized data comparing long-term outcomes of surgical versus the Ponseti treatment. We hypothesized that the conservative approach by Ponseti is the superior treatment to ensure best possible mobility in the ankle joint and therefore better functionality of the foot and higher life satisfaction of the affected children. The design is a single center, non-blinded, randomized, controlled analysis. Patients treated for idiopathic clubfoot from 2001 to 2003 by the Ponseti or the surgical treatment and participated in the previous study at our center in 2009 were invited. They underwent a medical examination, gait-analysis, x-ray examination of the foot and answered a questionnaire about life satisfaction. We used the Functional Rating System (FRS) as well as the Rating System by the International Clubfoot Study Group (ICFSG) to compare the morphology and functionality to the mobility, measured by 3D gait analysis, of the ankle joint. The Pediatric Outcomes Data Collection Instrument (PODCI) was used to rate the level of satisfaction. The physical and radiological examination according to the ICFSG & FRS protocols revealed a significantly better outcome within the Ponseti group. The Ponseti group excelled in terms of morphology and functionality and also showed better radiological outcomes compared to the surgically treated one. In the 3D gait analysis better maximal hind foot dorsiflexion and a more physiological gait pattern has been proven in the patients who received the conservative treatment according to Ponseti. Within the PODCI questionnaire this group also reported better physical functioning, less pain and a greater amount of happiness. The superior long-time outcome as well as the reduced need for additional surgery makes the Ponseti technique the treatment of choice.