Rizzo Esposito Ennio, Phillips Rachel, Leary Emily V, Gupta Sumit K
Orthopedic Surgery, University of Missouri, Columbia, USA.
Cureus. 2025 Mar 8;17(3):e80254. doi: 10.7759/cureus.80254. eCollection 2025 Mar.
Congenital talipes equinovarus (CTEV), or clubfoot, is one of the most common foot deformities seen at birth. The Ponseti technique is the most common method to treat clubfoot and consists of gentle manipulation with serial casting, a percutaneous Achilles tendon tenotomy, and bracing for the first few years of life. The purpose of this study was to determine whether socioeconomic factors influence compliance with clubfoot bracing for families with infants who have idiopathic clubfoot treated by the Ponseti method.
All patients with clubfoot deformity who began primary treatment at our pediatric orthopedic clinic between February 2018 and May 2021 were included in a retrospective chart review. Compliance was defined as strict adherence to the initial casting and tenotomy appointments, in addition to the caregiver's reported compliance with brace wear, and no mention of non-compliance in the patient's medical record. Recurrence was defined as relapse of the deformity after at least one year of follow-up and/or the need for additional casting or tenotomy.
Forty-three patients were included in the final analysis of compliance with bracing. No significant correlations were seen between the rate of compliance with bracing and any of the socioeconomic factors assessed in this study. The odds of noncompliance were 7.0 times higher in patients who had one or more missed clinic appointments, compared to those who attended all appointments (= 0.01). Forty-one patients were analyzed at a minimum one-year follow-up for recurrence of deformity. The odds ratio for recurrence of deformity in patients who were noncompliant with bracing was 74.8 compared to those who were compliant (=< 0.001).
Socioeconomic factors, including household income, education level, zip code, employment status of caregivers, and insurance status, were not associated with bracing compliance or recurrence of the clubfoot deformity. This was a level 2 observational study.
先天性马蹄内翻足（CTEV），即马蹄足，是出生时最常见的足部畸形之一。庞塞蒂方法是治疗马蹄足最常用的方法，包括手法轻柔的系列石膏固定、经皮跟腱切断术以及在生命的最初几年使用支具。本研究的目的是确定社会经济因素是否会影响采用庞塞蒂方法治疗特发性马蹄足的婴儿家庭对马蹄足支具治疗的依从性。
对2018年2月至2021年5月期间在我们儿科骨科诊所开始接受初步治疗的所有马蹄足畸形患者进行回顾性病历审查。依从性的定义为严格遵守初始石膏固定和切断术预约，此外，照顾者报告的支具佩戴依从性良好，且患者病历中未提及不依从情况。复发的定义为至少随访一年后畸形复发和/或需要额外的石膏固定或切断术。
43例患者纳入支具治疗依从性的最终分析。本研究评估的任何社会经济因素与支具治疗依从率之间均未发现显著相关性。与所有预约都按时就诊的患者相比，有一次或多次错过门诊预约的患者不依从的几率高7.0倍（P = 0.01）。41例患者接受了至少一年的随访以分析畸形复发情况。与依从支具治疗的患者相比，不依从支具治疗的患者畸形复发的比值比为74.8（P<0.001）。
社会经济因素，包括家庭收入、教育水平、邮政编码、照顾者就业状况和保险状况，与支具治疗依从性或马蹄足畸形复发无关。这是一项2级观察性研究。
