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

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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; Hägglund, Gunnar.

I: Acta Orthopaedica, Vol. 79, Nr. 1, 2008, s. 53-61.

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

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TY - JOUR

T1 - Comparison of serial casting and stretching technique in children with congenital idiopathic clubfoot: Evaluation of a new assessment system.

AU - Andriesse, Hanneke

AU - Hägglund, Gunnar

N1 - The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Division of Physiotherapy (Closed 2012) (013042000), Department of Orthopaedics (Lund) (013028000)

PY - 2008

Y1 - 2008

N2 - 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.

AB - 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.

U2 - 10.1080/17453670710014761

DO - 10.1080/17453670710014761

M3 - Article

VL - 79

SP - 53

EP - 61

JO - Acta Orthopaedica

T2 - Acta Orthopaedica

JF - Acta Orthopaedica

SN - 1745-3682

IS - 1

ER -