Monica P Nogueira1, Ana C D B F Queiroz, Alessandro G Melanda, Ana P Tedesco, Antonio L G Brandão, Claudio Beling, Francisco H Violante, Gilberto F Brandão, Laura F A Ferreira, Leandro S Brambila, Leopoldina M Leite, Jose L Zabeu, Jung H Kim, Kalyana E Fernandes, Marcia A S Arima, Maria D P Q Aguilar, Orlando C D Farias Filho, Oscar B D A Oliveira Filho, Solange D S Pinho, Paulo Moulin, Reinaldo Volpi, Mark Fox, Miles F Greenwald, Brandon Lyle, Jose A Morcuende. 1. *State Hospital of Sao Paulo (HSPE) #Associaton for Care of Desabled Children (AACD) **University Hospital of the University of Sao Paulo, São Paulo §§Pontifical Catholic University, Parque das Universidades-Campinas ##Vivendas Clinic, Sao Jose do Rio Preto §§§Child Municipal Hospital, Guarulhos ¶¶¶Hospital State University of Sao Paulo- UNESP, Botucatu, SP †Association for Disabled People of Alagoas ADEFAL, Maceió, AL ‡State University of Londrina (UEL), Paraná ††Orthopedic Hospital of Londrina, Londrina, PR §Neuro-orthopedic Institute, Caxias do Sul, RS ∥∥Orthopedics and Trauma Institute of Passo Fundo, RS ∥Santo Antonio Hospital Sister Dulce, Salvador, BA ¶Mineiro Orthopedic Institute, Belo Hortizonte, MG ‡‡‡Federal University of Uberlandia, Jardim Umuarama, MG ‡‡Mother and Child Unit of the University Hospital of Federal University of Maranhão (HUUFMA), São Luis, MA ¶¶Clinical Fracture Center of Children's Rehabilitation (CRI), Natal, Natal, RN ***São Zacharias Hospital, Rio de Janeiro, RJ †††Federal University of Paraiba, João Pessoa - PB ∥∥∥Children State Hospital Nossa Senhora da Gloria, Vitória, ES, Brazil ###Carver College of Medicine at the University of Iowa, Iowa City, IA.
Abstract
BACKGROUND: The Ponseti method has been shown to be the most effective treatment for congenital clubfoot. The current challenge is to establish sustainable national clubfoot treatment programs that utilize the Ponseti method and integrate it within a nation's governmental health system. The Brazilian Ponseti Program (Programa Ponseti Brasil) has increased awareness of the utility of the Ponseti method and has trained >500 Brazilian orthopaedic surgeons in it. METHODS: A group of 18 of those surgeons had been able to reproduce the Ponseti clubfoot treatment, and compiled their initial results through structured spreadsheet. RESULTS: The study compiled 1040 patients for a total of 1621 feet. The average follow-up time was 2.3 years with an average correction time of approximately 3 months. Patients required an average of 6.40 casts to achieve correction. CONCLUSIONS: This study demonstrates that good initial correction rates are reproducible after training; from 1040 patients only 1.4% required a posteromedial release. LEVEL OF EVIDENCE: Level IV.
BACKGROUND: The Ponseti method has been shown to be the most effective treatment for congenital clubfoot. The current challenge is to establish sustainable national clubfoot treatment programs that utilize the Ponseti method and integrate it within a nation's governmental health system. The Brazilian Ponseti Program (Programa Ponseti Brasil) has increased awareness of the utility of the Ponseti method and has trained >500 Brazilian orthopaedic surgeons in it. METHODS: A group of 18 of those surgeons had been able to reproduce the Ponseti clubfoot treatment, and compiled their initial results through structured spreadsheet. RESULTS: The study compiled 1040 patients for a total of 1621 feet. The average follow-up time was 2.3 years with an average correction time of approximately 3 months. Patients required an average of 6.40 casts to achieve correction. CONCLUSIONS: This study demonstrates that good initial correction rates are reproducible after training; from 1040 patients only 1.4% required a posteromedial release. LEVEL OF EVIDENCE: Level IV.