Drury, G.; Nunn, T.R.; Dandena, F.; Smythe, T.; Lavy, C.B.D. Treating Older Children with Clubfoot: Results of a Cross-Sectional Survey of Expert Practitioners. Int. J. Environ. Res. Public Health2023, 20, 6846.
Drury, G.; Nunn, T.R.; Dandena, F.; Smythe, T.; Lavy, C.B.D. Treating Older Children with Clubfoot: Results of a Cross-Sectional Survey of Expert Practitioners. Int. J. Environ. Res. Public Health 2023, 20, 6846.
Drury, G.; Nunn, T.R.; Dandena, F.; Smythe, T.; Lavy, C.B.D. Treating Older Children with Clubfoot: Results of a Cross-Sectional Survey of Expert Practitioners. Int. J. Environ. Res. Public Health2023, 20, 6846.
Drury, G.; Nunn, T.R.; Dandena, F.; Smythe, T.; Lavy, C.B.D. Treating Older Children with Clubfoot: Results of a Cross-Sectional Survey of Expert Practitioners. Int. J. Environ. Res. Public Health 2023, 20, 6846.
Abstract
Treating clubfoot in walking age children is debated, despite studies showing that using Ponseti casting principles can correct the mid-foot effectively. We aimed to explore techniques and approaches for management of older children with clubfoot and identify areas of management consensus. A mixed-methods cross-sectional electronic survey on delayed presenting clubfoot (DPC) was sent to 88 clubfoot practitioners (response rate 56.8%). We collected data on decision-making, casting, imaging, orthotics, surgery, re-currence, rehabilitation, multidisciplinary care and contextual factors. The quantitative data were analysed using descriptive statistics and the qualitative data were analysed using conventional content analysis. Many respondents used the Pirani score and some used the PAVER score to aid deformity severity assessment and correctability [1,2]. Ponseti casting principles were consistently applied with a stepwise approach. Con-textual factors influenced the timing of the treatment, the decision to treat a bilateral deformity simultaneously, and casting intervals. Differences were seen around orthotic usage and use of tibialis anterior tendon transfer following full correction. The survey identified consensus areas in overall principles of management for delayed presenting clubfoot and implementation of Ponseti principles, indicating these principles are well recognized as a multidisciplinary approach for older children with clubfoot. Some dif-ferences in approach may reflect different economic or social contexts. The principles can be adapted well for different geographical and healthcare contexts.
Public Health and Healthcare, Public, Environmental and Occupational Health
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