Svehlik Martin, Guggenberger Bernhard, Stöckler Michael, Klim Sebastian, Kraus Tanja
Pediatric and Adolescent Unit, Department of Trauma and Orthopedics, Medical University of Graz, 8036 Graz, Austria.
Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria.
Children (Basel). 2024 Nov 26;11(12):1422. doi: 10.3390/children11121422.
Idiopathic clubfoot is a common skeletal deformity in newborns that can cause functional limitations, pain, and reduced quality of life. The Ponseti method has become the gold standard for clubfoot treatment, replacing previous extensive surgical approaches. However, there is a lack of prospective long-term data comparing surgical and Ponseti treatments. This is a follow-up on a single-center, prospective, randomized clinical trial that started in 2001. The aim of this study was to compare the Ponseti method with surgical treatment. The current report presents the long-term results at adulthood of 12 clubfeet (9 subjects) in the Ponseti group and 9 clubfeet (5 subjects) in the surgical group. The evaluation included morphology, function, and quality of life, which were assessed through gait analysis, X-rays, and standardized questionnaires (FRS, ICFSG, AOFAS, SF-36). A Functional Rating System for clubfeet was defined as the primary outcome. The Ponseti group had higher Functional Rating System scores, better ankle dorsiflexion mobility, and lower pain levels. Additionally, they reported better quality of life according to the Short Form 36 survey. However, neither group achieved radiographically normal foot morphology. The 18-year follow-up results indicate that the Ponseti method produces superior outcomes in terms of mobility, gait, function, and quality of life when compared to surgically treated feet, despite the presence of persistent morphological deviations.
特发性马蹄内翻足是新生儿常见的骨骼畸形，可导致功能受限、疼痛和生活质量下降。庞塞蒂方法已成为马蹄内翻足治疗的金标准，取代了以往广泛的手术方法。然而，缺乏比较手术治疗和庞塞蒂治疗的前瞻性长期数据。这是一项对始于2001年的单中心、前瞻性、随机临床试验的随访。本研究的目的是比较庞塞蒂方法和手术治疗。本报告呈现了庞塞蒂组12例马蹄内翻足（9名受试者）和手术组9例马蹄内翻足（5名受试者）成年后的长期结果。评估包括形态、功能和生活质量，通过步态分析、X线检查和标准化问卷（FRS、ICFSG、AOFAS、SF-36）进行评估。定义了马蹄内翻足功能评分系统作为主要结局。庞塞蒂组的功能评分系统得分更高，踝关节背屈活动度更好，疼痛程度更低。此外，根据简短形式36调查，他们报告的生活质量更好。然而，两组均未达到足部形态在影像学上正常。18年的随访结果表明，与手术治疗的足部相比，庞塞蒂方法在活动度、步态、功能和生活质量方面产生了更好的结果，尽管存在持续的形态学偏差。
