J J Guerra-Jasso1, J A Valcarce-León2, H M Quíntela-Núñez-Del Prado3. 1. Hospital Regional de Alta Especialidad del Bajío. León, Guanajuato, México. 2. Departamento Clínico de Ortopedia Pediátrica, Hospital de Ortopedia, Unidad Médica de Alta Especialidad (UMAE) «Dr. Victorio de la Fuente Narváez», Instituto Mexicano del Seguro Social (IMSS). Colector 15 s/n (Av. Fortuna), Esq. Av. Politécnico Nacional, Col. Magdalena de las Salinas, Del. Gustavo A. Madero, CP 07760, Ciudad de México. México. 3. Servicio de Ortopedia Pediátrica, Hospital de Ortopedia, Unidad Médica de Alta Especialidad (UMAE) «Dr. Victorio de la Fuente Narváez», Instituto Mexicano del Seguro Social (IMSS). Colector 15 s/n (Av. Fortuna), Esq. Av. Politécnico Nacional, Col. Magdalena de las Salinas, Del. Gustavo A. Madero, CP 07760, Ciudad de México. México.
Abstract
BACKGROUND: Adduct congenital talipes equinovarus (CTE) or clubfoot is a common musculoskeletal malformation affecting between 1 and 4.5 out of every 1000 live births. It is usually associated with arthrogryposis and Moebius syndrome with the latter two being more difficult to treat as they require aggressive surgery to achieve a plantigrade foot. We therefore ask what is the evidence level and grade of recommendation of the Ponseti method to treat syndromic talipes equinovarus resulting from arthrogryposis and Moebius syndrome. METHODS: Systematic review according to the recommendations of the Cochrane group identifying medical subheadings (MeSH) and of the Boolean method to identify the articles that met the selection criteria through the search of primary sources such as OVID, Cochrane, EBSCOhost, Elsevier, Medigraphic. RESULTS: A total of six papers met the selection criteria through the search in the primary sources. Five of them address the treatment of adduct CTE with the Ponseti method in patients with arthrogryposis, and one in patients with Moebius. Evidence levels and grades of recommendation of these papers were: IV-D (3), III-D (1) y II (B). CONCLUSIONS: The Ponseti method is an first-line treatment for arthrogryposis and Moebius syndrome. It is unexpensive, non-invasive and does not require a physician to perform it (however, it does require trained staff). Its use is recommended as it avoids extensive surgeries and medical complications that go beyond the hospitals economic possibilities.
BACKGROUND: Adduct congenital talipes equinovarus (CTE) or clubfoot is a common musculoskeletal malformation affecting between 1 and 4.5 out of every 1000 live births. It is usually associated with arthrogryposis and Moebius syndrome with the latter two being more difficult to treat as they require aggressive surgery to achieve a plantigrade foot. We therefore ask what is the evidence level and grade of recommendation of the Ponseti method to treat syndromic talipes equinovarus resulting from arthrogryposis and Moebius syndrome. METHODS: Systematic review according to the recommendations of the Cochrane group identifying medical subheadings (MeSH) and of the Boolean method to identify the articles that met the selection criteria through the search of primary sources such as OVID, Cochrane, EBSCOhost, Elsevier, Medigraphic. RESULTS: A total of six papers met the selection criteria through the search in the primary sources. Five of them address the treatment of adduct CTE with the Ponseti method in patients with arthrogryposis, and one in patients with Moebius. Evidence levels and grades of recommendation of these papers were: IV-D (3), III-D (1) y II (B). CONCLUSIONS: The Ponseti method is an first-line treatment for arthrogryposis and Moebius syndrome. It is unexpensive, non-invasive and does not require a physician to perform it (however, it does require trained staff). Its use is recommended as it avoids extensive surgeries and medical complications that go beyond the hospitals economic possibilities.
Authors: Kyle Korth; Scott Bolam; Ellen Leiferman; Thomas Crenshaw; Michael Dray; Haemish A Crawford; Maegen Wallace; Matthew A Halanski Journal: J Child Orthop Date: 2021-10-01 Impact factor: 1.548