Document Type

Article

Language

eng

Publication Date

8-2-2017

Publisher

Lippincott Williams and Wilkins

Source Publication

Journal of Pediatric Orthopaedics

Source ISSN

0271-6798

Original Item ID

DOI: 10.1097/BPO.0000000000001060

Abstract

Background:

Individuals with clubfoot, treated in infancy with either the Ponseti method or comprehensive clubfoot release, often encounter pain as adults. Multiple studies have characterized residual deformity after Ponseti or surgical correction using physical exam, radiographs and pedobarography; however, the relationship between residual foot deformity and pain is not well defined. The purpose of the current study was 2-fold: (1) to evaluate the relationship between foot morphology and pain for young adults treated as infants for idiopathic clubfoot and (2) to describe and compare pedobarographic measures and outcome measures of pain and morphology among surgically treated, Ponseti treated, and typically developing feet.

Methods:

We performed a case-control study of individuals treated for clubfoot at 2 separate institutions with either the Ponseti method or comprehensive clubfoot release between 1983 and 1987. All subjects (24 treated with comprehensive clubfoot release, 18 with Ponseti method, and 48 controls) were evaluated using the International Clubfoot Study Group (ICFSG) morphology scoring, dynamic pedobarography, and foot function index surveys. During pedobarography, we collected the subarch angle and arch index as well as the center of pressure progression (COPP) on all subjects.

Results:

Foot morphology (ICFSG) scores were highly correlated with foot function index pain scores (r=0.43; P

Conclusions:

Measures of foot morphology were correlated with pain among all treated for clubfoot. Compared with Ponseti method, comprehensive surgical release lead to greater long-term foot deformity, flatter feet and greater hindfoot loading time.

Level of Evidence:

Level III—Therapeutic.

Comments

Accepted version. Journal of Pediatric Orthopaedics, Vol. 39, No.10 (November/December 2019): 527-533. DOI. © 2019 Lippincott Williams & Wilkins. Used with permission.

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