Seidel Angela, Tinembart Severine, Kaiser Nadine, Ziebarth Kai
Departement of Orthopedic Surgery and Traumatology, University of Fribourg, Fribourg, CHE.
Department of Pediatric Surgery, Inselspital, University of Berne, Berne, CHE.
Cureus. 2025 Mar 8;17(3):e80260. doi: 10.7759/cureus.80260. eCollection 2025 Mar.
Background The Ponseti method is the most frequent method for clubfoot treatment. It includes a six-year night-splinting period, which is difficult to comply with. The objective of this study is to evaluate the clinical outcomes, recurrence rates, and patient-reported health-related quality of life following a modified Ponseti method with reduced night splinting duration. Methods We analyzed 107 children (77 boys, 30 girls, 152 clubfeet) who were treated for idiopathic clubfoot from January 1994 to January 2015. The initial treatment started at a mean age of 9.2 days. Long-leg Soft Casts TM3 were applied until the desired position of the foot was achieved. At a mean age of 3.2 months, the residual deformity was corrected surgically. We assessed the clinical outcome by chart review and the functional outcome by a questionnaire that included the disease specific instrument (DSI) and the health-related quality of life assessed by the pediatric quality of life inventory (PedsQL™). Results In 101 patients (92.7%) and 142 feet (93.4%), we had a clinical follow-up at a mean age of 7.39±4.9 years. A Denise Brown splint or a unilateral orthosis was applied for a mean period of 7.8±4.8 months over the whole day and an additional 17.3 ±16.3) nights only. At a mean follow-up of 10.0±SD 6.2 years, 82.2% of patients returned the questionnaires. The mean DSI was 74.8±17.5. The mean overall PedsQL™ was 87.8±12.6. The PedsQL™ functional component score showed a mean of 89.4±5.6, and the PedsQL™ social component score a mean of 86.9±13.5. Ten (9.3%) patients had a bilateral, and 18 (16.8%) patients had a unilateral relapse. Conclusions Achilles tendon lengthening (ATL) and limited posterior release, followed by a reduced period of splinting of 2.1 years, provide similar results compared to the original Ponseti method.
庞塞蒂方法是治疗马蹄内翻足最常用的方法。它包括一个为期六年的夜间支具治疗期，这很难坚持。本研究的目的是评估采用缩短夜间支具佩戴时间的改良庞塞蒂方法后的临床疗效、复发率以及患者报告的与健康相关的生活质量。方法：我们分析了1994年1月至2015年1月期间接受特发性马蹄内翻足治疗的107名儿童（77名男孩，30名女孩，152只患足）。初始治疗开始时的平均年龄为9.2天。应用长腿软石膏TM3直至达到足部的理想位置。在平均年龄3.2个月时，通过手术矫正残余畸形。我们通过病历回顾评估临床疗效，通过一份问卷评估功能疗效，该问卷包括疾病特异性工具（DSI）以及通过儿童生活质量量表（PedsQL™）评估的与健康相关的生活质量。结果：101名患者（92.7%）和142只患足（93.4%）在平均年龄7.39±4.9岁时接受了临床随访。丹妮丝·布朗支具或单侧矫形器全天平均佩戴7.8±4.8个月，仅额外佩戴17.3±16.3个夜晚。在平均随访10.0±标准差6.2年时，82.2%的患者返回了问卷。DSI的平均值为74.8±17.5。PedsQL™的总体平均值为87.8±于12.6。PedsQL™功能成分得分的平均值为89.4±5.6，PedsQL™社会成分得分的平均值为86.9±±13.5。10名（9.3%）患者出现双侧复发，18名（16.8%）患者出现单侧复发。结论：与原始庞塞蒂方法相比，跟腱延长术（ATL）和有限的后路松解术，随后将支具佩戴时间缩短至2.1年，可提供相似的结果。
