Department of Biomechanical Engineering, University of Twente, Enschede, the Netherlands.
Department of Orthopaedic Surgery, Catharina Hospital Eindhoven, Eindhoven, the Netherlands.
PLoS One. 2018 Jun 22;13(6):e0199540. doi: 10.1371/journal.pone.0199540. eCollection 2018.
Clubfeet are commonly treated using the Ponseti method. This method involves weekly manipulation and casting which gradually corrects the position of the foot. However, the reasons for following a weekly interval are not clear.
QUESTION / PURPOSE: The aim is to investigate the influence of the cast change interval on treatment outcomes in the Ponseti method.
We performed a systematic review of comparative studies in which the cast change interval was varied. Scientific databases were searched for relevant publications, screened for eligibility and assessed for a risk of bias. A 'best evidence' synthesis tool was used to synthesize the results of the included studies and draw conclusions from relevant clinical outcomes.
Nine papers matched the inclusion criteria, which provided data of 587 subjects who had a total of 870 clubfeet. There is strong evidence for a positive relation between cast change interval and treatment duration. However, there is no evidence for any relation between the cast change interval and the required number of casts, tenotomy rate, required surgery or failure rate.
Accelerated versions are as effective and safe as the traditional Ponseti method. However, more research is needed to assess the long-term results and to identify an optimal cast change interval.
足内翻通常采用 Ponseti 方法治疗。该方法通过每周的手法复位和石膏固定逐渐矫正足部位置。但是，这种每周治疗间隔的依据并不明确。
问题/目的：本研究旨在探讨 Ponseti 方法中石膏更换间隔对治疗效果的影响。
我们对改变石膏更换间隔的对比研究进行了系统综述，检索了相关文献，筛选出合格文献并评估了偏倚风险。采用“最佳证据综合”工具对纳入研究的结果进行综合分析，并得出相关临床结局的结论。
9 篇文献符合纳入标准，共纳入 587 例患者 870 足，这些患者的治疗数据具有很强的证据表明石膏更换间隔与治疗持续时间呈正相关。但是，目前没有证据表明石膏更换间隔与所需石膏固定次数、跟腱切断率、手术需求或失败率之间存在任何关系。
加速治疗版本与传统 Ponseti 方法同样有效且安全。但是，需要更多的研究来评估长期疗效，并确定最佳的石膏更换间隔。
