The use of botulinum type A toxin in the treatment of idiopathic XXXX : 5-year follow-up.

@entity1 @entity5149
BACKGROUND: Continued monitoring and reporting of outcomes in @entity5149 @entity1 are important for providing an indicator of functional outcomes and surveillance and treatment for problems or recurrences. The purpose of this study is to report the 5-year outcomes of the updated cohort of 44 @entity1 with 65 idiopathic clubfeet treated with manipulation, casting, and Botulinum toxin A (BTX-A). METHODS: As part of the original study, the @entity1 underwent the corrective treatment phase of manipulation and casting followed with BTX-A injection and then the maintenance phase of bracing. The @entity1 were seen at regular intervals and a detailed clinical history was maintained for each @entity1 including ankle range of motion, recurrences, and interventions for recurrences. RESULTS: Mean values for range of motion at the 5-year visit were 22.3 and 17.1 degrees for dorsiflexion with the knee in flexion and extension, respectively. Overall, 48% (31 of 65 clubfeet) successfully responded to a single BTX-A injection and experienced no recurrence over the follow-up period. At least 1 repeat BTX-A injection was required in 34 clubfeet, for an overall recurrence rate of 52%. Surgery was required in 10 clubfeet, and the overall surgical rate was 15.4%. CONCLUSIONS: Idiopathic clubfeet treated with BTX-A continued to show good outcomes at 2 to 5-year follow-up. The experience with this cohort provides support for the effectiveness of BTX-A in the initial correction and continued management of idiopathic @entity5149 . LEVEL OF EVIDENCE: Levels III to IV. This is a prospective, nonexperimental clinical study investigating efficacy of an innovative treatment.
