McCartney Sarah, Turner Sarah, Davies Kirsty, Morris Jan, Sproston Claire, Kiely Nigel
1 Great Western Hospital, Swindon, UK.
2 Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, UK.
Prosthet Orthot Int. 2019 Jun;43(3):325-330. doi: 10.1177/0309364618814866. Epub 2018 Dec 17.
The Ponseti method for treating congenital talipes equinovarus requires an orthosis to maintain correction after manipulation and casting, typically the 'boots and bar'. Non-compliance with the orthosis increases the risk of recurrent deformity. This study investigates a new orthosis, the abduction dorsiflexion mechanism.
The aim of this study is to assess compliance of the abduction dorsiflexion mechanism when used at night and maintenance of foot morphology.
This study is a cohort study.
A total of 10 children with unilateral congenital talipes equinovarus previously treated with Ponseti casting were recruited to trial the abduction dorsiflexion mechanism at night for 12 weeks. Foot morphology and compliance were assessed every 4 weeks.
Participant families were pleased with the orthosis, opting to continue to use the device following conclusion of the trial. Compliance was good and no deterioration in Pirani score or dorsiflexion seen. Abduction improved during the trial. The incidence of skin problems was equivalent to that experienced with the traditional boots and bar that the children had been wearing.
Good compliance and parental satisfaction, coupled with no deterioration in foot morphology, abduction or dorsiflexion present the abduction dorsiflexion mechanism boot as a feasible alternative to the traditional boots and bar, particularly in children with unilateral congenital talipes equinovarus.
The abduction dorsiflexion mechanism is currently the subject of considerable interest as clinicians look to increase compliance and reduce the recurrence rate in Ponseti-treated congenital talipes equinovarus. The abduction dorsiflexion mechanism boot is a feasible alternative to the traditional boots and bar, particularly in children with unilateral congenital talipes equinovarus.
庞塞蒂方法治疗先天性马蹄内翻足在手法复位和石膏固定后需要使用矫形器来维持矫正效果，通常使用的是“靴子和横杆”矫形器。不遵守矫形器使用规定会增加畸形复发的风险。本研究调查一种新型矫形器——外展背屈装置。
本研究旨在评估外展背屈装置在夜间使用时的依从性以及足部形态的维持情况。
本研究为队列研究。
共招募10名曾接受庞塞蒂石膏固定治疗的单侧先天性马蹄内翻足患儿，试用外展背屈装置夜间佩戴12周。每4周评估一次足部形态和依从性。
参与研究的患儿家庭对该矫形器满意，在试验结束后选择继续使用该装置。依从性良好，皮拉尼评分和背屈功能未见恶化。试验期间外展功能有所改善。皮肤问题的发生率与患儿之前佩戴的传统靴子和横杆矫形器相当。
良好的依从性和家长满意度，以及足部形态、外展功能和背屈功能均未恶化，表明外展背屈装置矫形器是传统靴子和横杆矫形器的可行替代方案，尤其适用于单侧先天性马蹄内翻足患儿。
外展背屈装置目前备受关注，因为临床医生希望提高庞塞蒂治疗的先天性马蹄内翻足的依从性并降低复发率。外展背屈装置矫形器是传统靴子和横杆矫形器可行的替代方案，尤其适用于单侧先天性马蹄内翻足患儿。
