Walking age of infants with idiopathic clubfoot treated using the ponseti method. 2014

Lewis E Zionts, and Davida F Packer, and Shannon Cooper, and Edward Ebramzadeh, and Sophia Sangiorgio
Orthopaedic Institute for Children, 403 West Adams Boulevard, Los Angeles, CA 90007. E-mail address: LZionts@mednet.ucla.edu.

BACKGROUND The Ponseti method is an established approach to treating idiopathic clubfoot in infants. The method involves a period of cast immobilization and postcorrective bracing that potentially interferes with normal movements of the lower extremities. In the present study, we investigated the age at which infants who had idiopathic clubfoot treated using the Ponseti method achieved independent walking. METHODS We prospectively evaluated patients of a single surgeon. Included in the study were all patients with idiopathic clubfoot who were full term at birth, were no more than twelve weeks of age at the start of treatment, had received no prior outside treatment, and were followed for a minimum of twenty-four months. RESULTS Ninety-four patients were included. The mean age at which patients began walking independently was 14.5 ± 2.6 months (range, ten to twenty-two months). By eighteen months, 90% of the patients were walking without assistance. Patients with moderate or severe clubfoot deformity began walking earlier than did patients with very severe deformity (a mean of 14.2 months compared with 15.8 months; p = 0.03). Patients who experienced a relapse before learning to walk began walking later than those who did not relapse (a mean of 15.9 months compared with 14.2 months; p = 0.04). Other patient and treatment-related variables had no significant influence on the onset of walking. CONCLUSIONS On the basis of our findings, parents of infants with idiopathic clubfoot treated using the Ponseti method may expect their child to achieve independent walking approximately two months later than infants without clubfoot deformity. A greater delay may be expected for those patients who have a very severe deformity or those who experience a deformity relapse. METHODS Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008297 Male Males
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D012149 Restraint, Physical Use of a device for the purpose of controlling movement of all or part of the body. Splinting and casting are FRACTURE FIXATION. Immobilization, Physical,Physical Restraint,Physical Immobilization,Physical Restraints,Restraints, Physical
D001915 Braces Orthopedic appliances used to support, align, or hold parts of the body in correct position. (Dorland, 28th ed) Brace
D002370 Casts, Surgical Dressings made of fiberglass, plastic, or bandage impregnated with plaster of paris used for immobilization of various parts of the body in cases of fractures, dislocations, and infected wounds. In comparison with plaster casts, casts made of fiberglass or plastic are lightweight, radiolucent, able to withstand moisture, and less rigid. Fiberglass Casts,Plaster Casts,Plastic Casts,Cast, Surgical,Surgical Cast,Surgical Casts,Cast, Fiberglass,Cast, Plaster,Cast, Plastic,Casts, Fiberglass,Casts, Plaster,Casts, Plastic,Fiberglass Cast,Plaster Cast,Plastic Cast
D002657 Child Development The continuous sequential physiological and psychological maturing of an individual from birth up to but not including ADOLESCENCE. Infant Development,Development, Child,Development, Infant
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D003025 Clubfoot A deformed foot in which the foot is plantarflexed, inverted, and adducted. Equinovarus,Talipes Equinovarus,Clubfeet,Clubfeet, Congenital,Clubfoot, Congenital,Congenital Talipes Equinovarus,Pie Torcido,Congenital Clubfeet,Congenital Clubfoot,Pie Torcidos,Talipes Equinovarus, Congenital
D005260 Female Females

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