Morcuende Jose A, Egbert Martin, Ponseti Ignacio V
Department of Orthopaedic Surgery, University of Iowa, Iowa City, IA 52242, USA.
Iowa Orthop J. 2003;23:83-6.
Parents have traditionally relied on health care professionals for advice and treatment for most orthopaedic conditions, including clubfoot. However, the unprecedented access to health care information offered by the Internet is changing how parents gather information and make treatment choices. This study was designed to evaluate the effect of the Internet in the treatment of clubfoot. We performed a retrospective review of the clinical census, statistics of the Virtual Hospital web pages on clubfoot, web sites, and web based support-groups related to clubfoot from 1995 to 2002. There were 157 patients that came to our clinic for treatment, a dramatic increase compared to previous years. There were a total of 790,084 hits to the Virtual Hospital web pages, with information requested from all states and 72 countries. Interestingly, the referrals also changed with patients coming from 30 states and 8 different countries, compared to previous years when the majority came from our own state. In addition, 75% of the patients were self-referred, many of them while on treatment at outside institutions. There were 160 web sites providing information on clubfoot and 5 large support groups. There were approximately 30,000 messages (average 1000 messages/month) posted into the support clubfoot websites. After visiting Internet support groups, 125 parents transferred or initiated the care of their children to a doctor practicing the Ponseti method. In conclusion, the Internet provides a mean for parents to obtain disease-specific information in a timely manner. Parents used the support-groups to find and proffer information, share experiences and opinions, and provide encouragement. This sharing of information is affecting how parents make their treatment choices and also has the potential to induce unexpected changes in clinical orthopaedic practice.
传统上，对于包括马蹄内翻足在内的大多数骨科疾病，家长们都依赖医疗保健专业人员提供建议和治疗。然而，互联网前所未有的医疗保健信息获取途径正在改变家长们收集信息和做出治疗选择的方式。本研究旨在评估互联网在马蹄内翻足治疗中的作用。我们对1995年至2002年虚拟医院关于马蹄内翻足的网页、网站以及基于网络的支持小组的临床普查和统计数据进行了回顾性研究。有157名患者前来我们诊所接受治疗，与前几年相比有显著增加。虚拟医院网页的总点击量为790,084次，信息请求来自美国所有州和72个国家。有趣的是，转诊情况也发生了变化，患者来自30个州和8个不同国家，而前几年大多数患者来自我们所在的州。此外，75%的患者是自行转诊的，其中许多人当时正在外部机构接受治疗。有160个网站提供有关马蹄内翻足的信息以及5个大型支持小组。支持马蹄内翻足的网站上大约发布了30,000条信息（平均每月1000条信息）。在访问互联网支持小组后，125名家长将孩子的护理转给了采用庞塞蒂方法治疗的医生或开始寻求其治疗。总之，互联网为家长及时获取特定疾病信息提供了一种途径。家长们利用支持小组查找和提供信息、分享经验和意见并给予鼓励。这种信息共享正在影响家长们做出治疗选择的方式，并且也有可能在临床骨科实践中引发意想不到的变化。
