Does idiopathic congenital talipes equinovarus have an impact on attainment of developmental milestones? A multicentre international study

被引:8
作者
Hughes, K. [1 ]
Gelfer, Y. [1 ,2 ]
Cokljat, M. [1 ]
Wientroub, S. [3 ]
Hemo, Y. [3 ]
Dunkley, M. [4 ,5 ,6 ]
Eastwood, D. M. [4 ,5 ]
机构
[1] St George Hosp, London, England
[2] St Georges Univ London, London, England
[3] Dana Childrens Hosp, Tel Aviv, Israel
[4] Great Ormond St Hosp Sick Children, London, England
[5] UCL, London, England
[6] Royal Surrey Cty Hosp, Guildford, Surrey, England
关键词
Clubfoot; developmental milestones; Ponseti; PONSETI METHOD; MOTOR MILESTONES; CLUBFOOT; CHILDREN;
D O I
10.1302/1863-2548.13.190060
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
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.
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页码:353 / 360
页数:8
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