182
· DOS Abstracts
Treatment of clubfoot: Comparing surgical
correction and the Ponseti Method –
A comparative study
Mette Tavlo, Lise Karlsmark, Klaus Hindsø
Børneortopædkirurgisk Sektion, HovedOrtoCentret, Rigshospitalet; Klinik for
Ergo- og Fysioterapi, Rigshospitalet
Background:
From 2005 – 2007 two treatments for clubfoot (CF) were of-
fered at Rigshospitalet: the Ponseti and the Copenhagen method (Cph.), which
is a surgical procedure. During this period parents chose the treatment.
Purpose / Aim of Study:
This study aimed to compare mechanical and patient
related outcome measures (PROMS) between the treatments.
Materials and Methods:
A consecutive series of 28 patients met the inclusion
criteria. 23 patients with 33 CF participated. The mechanical outcome mea-
sures were pedobarographicly collected as heel/foot peak pressure, contact-
area-quotient, centre of pressure deviation and heel-foot angle. Mechanical
parameters were chosen as they represented CF deformities: cavus, hindfoot
and forefoot adduction. PROMS regarding appearance and function were scored
by the child and parents using a visual analog scale (0 – 100).
Findings / Results:
Relapse rate did not differ between treatment groups
(Ponseti 33%, Cph. 36%). Appearance- (VAS-mean Ponseti 5.2, Cph. 12.8, p
= 0.01) and functional-limitation (VAS-mean Ponseti 5.5, Cph. 12.6, p = 0.01)
differed significantly in favour of Ponseti. Children with bilateral CF were found
to be significant more satisfied (VAS-mean unilat. 21.6, bilat. 13.5, p = 0.02)
with their feet compared to children with unilateral CF. No pedobarographic pa-
rameters differed between treatment groups.
Conclusions:
Ponseti treatment of idiopatic clubfoot seems to yield better
PROMS than surgical correction. The treatments resulted in equal mechanical
properties when measured during gait in a pedobarographical analysis.
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