Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt.
Department of Orthopaedic Surgery, Nasr City Health Insurance Hospital, Cairo, Egypt.
Int Orthop. 2022 Feb;46(2):313-319. doi: 10.1007/s00264-021-05107-0. Epub 2021 Jun 13.
To compare the foot external rotation above-knee (FERAK) brace and the Denis Browne boot (DBB) brace in terms of relapse prevention and parents' compliance after successful correction with Ponseti casting.
A single-centre, randomized controlled study was conducted between 2016 and 2020. A total of 60 feet in 38 patients with idiopathic clubfoot initially corrected with the Ponseti method were included. They were randomized into two equal groups: the FERAK group and the DBB group. The primary outcome was the efficacy in maintaining correction measured by the Pirani score. The secondary outcomes were parents' compliance and complications (e.g., relapses, skin complications).
The follow-up period was 24 months for each patient. The mean final Pirani score was 0.42 ± 0.76 in the FERAK group and 0.57 ± 0.82 in the DBB group. This difference was statistically insignificant (p-value = 0.411). Regarding parents' compliance in the FERAK group, 86.7% of parents had good and intermediate compliance while 13.3% had bad compliance. In the DBB group, 66.7% had good and intermediate compliance while 33.3% had bad compliance. This difference was also statistically insignificant (p-value = 0.118).
Both braces achieved good comparable outcomes after Ponseti casting. However, the FERAK brace yielded slightly better parents' compliance with a less recurrence rate.
比较经皮跟腱切断术（Ponseti）石膏矫形后应用膝上外旋足支具（FERAK）和 Denis Browne 靴（DBB）支具预防复发的效果及家长依从性。
这是一项单中心、随机对照研究，于 2016 年至 2020 年进行。共纳入 38 例特发性马蹄内翻足患者的 60 足，这些患者的足部经 Ponseti 方法治疗后初始矫正成功。将他们随机分为两组：FERAK 组和 DBB 组。主要结局是通过 Pirani 评分评估维持矫正的效果。次要结局是家长的依从性和并发症（如复发、皮肤并发症）。
每位患者的随访期为 24 个月。FERAK 组的平均最终 Pirani 评分为 0.42±0.76，DBB 组为 0.57±0.82。两组间差异无统计学意义（p 值=0.411）。在 FERAK 组中，86.7%的家长依从性良好或中等，13.3%的家长依从性差。在 DBB 组中，66.7%的家长依从性良好或中等，33.3%的家长依从性差。两组间差异也无统计学意义（p 值=0.118）。
两种支具在经 Ponseti 石膏矫形后均取得了良好的可比结果。然而，FERAK 支具在家长依从性方面略有优势，且复发率略低。
