Sheta Reda Ali, El-Sayed Mohamed, Abdel-Ghani Hisham, Saber Sameh, Mohammed Amani Salah Eldin, Hassan Tohamy Gouda Tohamy
Professor of Orthopaedics, Al-Ahrar Specialist Hospital, Zagazig, Al-Sharkia, Egypt.
Professor of Pediatric Orthopedics & Limb Reconstructive -Surgeries, Tanta University, Egypt.
J Child Orthop. 2021 Oct 1;15(5):433-442. doi: 10.1302/1863-2548.15.210038.
We aimed to compare our parent-based exercise programem's efficacy with the foot abduction brace (FAB) Ponseti manipulation as a retention programme.
We conducted this prospective multicentre cohort study between August 2009 and November 2019. The included children were allocated into one of two groups according to the retention protocol. The Pirani and Laaveg-Ponseti scores were used to assess the feet clinically and functionally. Radiological assessment was performed using standing anteroposterior and lateral radiographs of the feet. We assessed the parents' satisfaction and adherence to the retention method. SPSS version 25 was used for the statistical analysis.
A total of 1265 feet in 973 children were included. Group A included 637 feet managed with FAB, while group B included 628 feet managed with our retention programme. All patients were followed up to the age of four years. At the final follow-up, Pirani scores in group A participants were excellent, good and poor in 515, 90, and 32 feet, respectivel, while in group B the scores were excellent, good and poor in 471, 110 and 44 feet, respectively. The mean total score of Laaveg-Ponseti was 87.81 (sd 19.82) in group A and 90.55 (sd 20.71) in group B (p = 0.02). Group B participants showed higher satisfaction with the treatment method (p = 0.011) and more adherence to the treatment (p = 0.013).
The deformity's recurrence related to the brace's non-compliance in the Ponseti method might be reduced by substituting the brace with our home-based daily stretching exercises.
II.
我们旨在比较以家长为基础的锻炼计划与足部外展支具（FAB）在庞塞蒂手法治疗后的维持治疗方案中的疗效。
我们在2009年8月至2019年11月期间进行了这项前瞻性多中心队列研究。根据维持治疗方案，将纳入的儿童分为两组。使用皮拉尼和拉维格-庞塞蒂评分对足部进行临床和功能评估。通过站立位足部前后位和侧位X线片进行影像学评估。我们评估了家长对维持治疗方法的满意度和依从性。使用SPSS 25版进行统计分析。
共纳入973名儿童的1265只脚。A组包括637只采用FAB治疗的脚，而B组包括628只采用我们的维持治疗方案的脚。所有患者均随访至4岁。在最后一次随访时，A组参与者的皮拉尼评分中，优秀、良好和差的分别有515只、90只和32只脚，而B组中优秀、良好和差的分别有471只、110只和44只脚。A组拉维格-庞塞蒂总分的平均值为87.81（标准差19.82），B组为90.55（标准差20.71）（p = 0.02）。B组参与者对治疗方法的满意度更高（p = 0.011），对治疗的依从性也更好（p = 0.013）。
通过用我们基于家庭的日常伸展运动替代支具，可以减少庞塞蒂方法中因支具使用不依从导致的畸形复发。
II级。
