Shack N, Eastwood D M
Department of Physiotherapy, The Royal Free Hospital, Pond Street, London NW3 2QG, UK.
J Bone Joint Surg Br. 2006 Aug;88(8):1085-9. doi: 10.1302/0301-620X.88B8.17919.
We studied 24 children (40 feet) to demonstrate that a physiotherapist-delivered Ponseti service is as successful as a medically-led programme in obtaining correction of an idiopathic congenital talipes equinovarus deformity. The median Pirani score at the start of treatment was 5.5 (mean 4.75; 2 to 6). A Pirani score of > or =5 predicted the need for tenotomy (p < 0.01). Of the 40 feet studied, 39 (97.5%) achieved correction of deformity. The remaining foot required surgical correction. A total of 25 (62.5%) of the feet underwent an Achilles tenotomy, which was performed by a surgeon in the physiotherapy clinic. There was full compliance with the foot abduction orthoses in 36 (90%) feet. Continuity of care was assured, as one practitioner was responsible for all patient contact. This was rated highly by the patient satisfaction survey. We believe that the Ponseti technique is suitable for use by non-medical personnel, but a holistic approach and good continuity of care are essential to the success of the programme.
我们对24名儿童（40只脚）进行了研究，以证明由物理治疗师提供的庞塞蒂疗法在矫正特发性先天性马蹄内翻足畸形方面与由医学主导的方案同样成功。治疗开始时皮拉尼评分的中位数为5.5（平均4.75；范围2至6）。皮拉尼评分≥5预示需要进行跟腱切断术（p<0.01）。在研究的40只脚中，39只（97.5%）实现了畸形矫正。其余一只脚需要手术矫正。共有25只（62.5%）脚接受了跟腱切断术，由外科医生在物理治疗诊所进行。36只（90%）脚完全依从足部外展矫形器。由于一名从业者负责所有患者接触，护理的连续性得到了保证。患者满意度调查对此评价很高。我们认为庞塞蒂技术适合非医务人员使用，但整体方法和良好的护理连续性对该方案的成功至关重要。
