Mid-term results of a physiotherapist-led Ponseti service for the management of non-idiopathic and XXXX .

@entity1 @entity85 @entity5149
BACKGROUND: The Ponseti method is the preferred treatment for @entity5149 . Although popularised by orthopaedic surgeons it has expanded to physiotherapists and other health practitioners. This study reviews the results of a physiotherapist-led Ponseti service for idiopathic and non-idiopathic clubfeet and compares these results with those reported by other groups. METHOD: A prospective cohort of clubfeet (2005-2012) with a minimum 2-year follow-up after correction was reviewed. Physiotherapists treated 91 @entity1 -41 @entity1 (69 feet) had @entity85 and 50 @entity1 (77 feet) were idiopathic. Objective outcomes were evaluated and compared to results from other groups managing similar @entity1 cohorts. RESULTS: The mean follow-up was 4.6  years (range 2-8.3  years) for both groups. The non-idiopathic group required a median of 7 casts to correct the @entity85 with an 83  % tenotomy rate compared to a median of 5 casts for the idiopathic group with a 63  % tenotomy rate. Initial correction was achieved in 96  % of non-idiopathic feet and in 100  % of idiopathic feet. Recurrence requiring additional treatment was higher in the non-idiopathic group with 40  % of @entity1 (36  % of feet) sustaining a relapse as opposed to 8  % (6  % feet) in the idiopathic group. Surgery was required in 26  % of relapsed non-idiopathic feet and 6  % of idiopathic. CONCLUSIONS: Although Ponseti treatment was not as successful in non-idiopathic feet as in idiopathic feet, deformity correction was achieved and maintained in the mid-term for the majority of feet. These results compare favourably to other specialist orthopaedic-based services for Ponseti management of non-idiopathic clubfeet. LEVEL OF EVIDENCE: Prognostic Level III.
