The Ponseti Method in Children with Clubfoot after Walking Age: Systematic Review and Metanalysis
Category: Clubfoot Introduction/Purpose: The prevalence of untreated congenital clubfoot among children older than walking age is higher in developing countries due to limited resources for early care after birth. The Ponseti method represents an intervention option for older, untreated children. Me...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2019-10-01
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| Series: | Foot & Ankle Orthopaedics |
| Online Access: | https://doi.org/10.1177/2473011419S00409 |
| _version_ | 1811333239426514944 |
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| author | Kelly Cristina Stéfani MD, PhD Davi de Podestá Haje MD, PhD Monica Paschoal Nogueira MD |
| author_facet | Kelly Cristina Stéfani MD, PhD Davi de Podestá Haje MD, PhD Monica Paschoal Nogueira MD |
| author_sort | Kelly Cristina Stéfani MD, PhD |
| collection | DOAJ |
| description | Category: Clubfoot Introduction/Purpose: The prevalence of untreated congenital clubfoot among children older than walking age is higher in developing countries due to limited resources for early care after birth. The Ponseti method represents an intervention option for older, untreated children. Methods: A metanalysis was conducted of observational studies selected through a systematic review of articles included in electronic databases (Medline, Scopus, Embase, Lilacs, and the Cochrane Library) until June 2017. A pooling analysis of proportions with 95% confidence intervals (CIs) and a publication bias assessment were performed as routine. Estimates of success, recurrence, and complication rates were weighted and pooled using the random effects model. Results: Twelve studies, including 654 feet diagnosed with congenital clubfoot in children older than walking age (older than 1 year old), were included for analysis. The rate of satisfactory outcomes found via a cluster metanalysis of proportions using the random effects model was 89% (95% CI = 0.82–0.94, p < 0.01), relative to the total analysed. The recurrence rate was 18% (95% CI = 0.14–0.24, p = 0.015), and the rate of casting complications was 7% (95% CI = 0.03–0.15, p = 0.19). Conclusion: Application of the Ponseti method in children with untreated idiopathic clubfoot older than walking age leads to satisfactory outcomes, has a low cost, and avoids surgical procedures likely to cause complications. The results obtained exhibited considerable heterogeneity. |
| first_indexed | 2024-04-13T16:49:51Z |
| format | Article |
| id | doaj.art-033ea9e15f9e4731b5c13f1d577b33c1 |
| institution | Directory Open Access Journal |
| issn | 2473-0114 |
| language | English |
| last_indexed | 2024-04-13T16:49:51Z |
| publishDate | 2019-10-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Foot & Ankle Orthopaedics |
| spelling | doaj.art-033ea9e15f9e4731b5c13f1d577b33c12022-12-22T02:38:58ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142019-10-01410.1177/2473011419S00409The Ponseti Method in Children with Clubfoot after Walking Age: Systematic Review and MetanalysisKelly Cristina Stéfani MD, PhDDavi de Podestá Haje MD, PhDMonica Paschoal Nogueira MDCategory: Clubfoot Introduction/Purpose: The prevalence of untreated congenital clubfoot among children older than walking age is higher in developing countries due to limited resources for early care after birth. The Ponseti method represents an intervention option for older, untreated children. Methods: A metanalysis was conducted of observational studies selected through a systematic review of articles included in electronic databases (Medline, Scopus, Embase, Lilacs, and the Cochrane Library) until June 2017. A pooling analysis of proportions with 95% confidence intervals (CIs) and a publication bias assessment were performed as routine. Estimates of success, recurrence, and complication rates were weighted and pooled using the random effects model. Results: Twelve studies, including 654 feet diagnosed with congenital clubfoot in children older than walking age (older than 1 year old), were included for analysis. The rate of satisfactory outcomes found via a cluster metanalysis of proportions using the random effects model was 89% (95% CI = 0.82–0.94, p < 0.01), relative to the total analysed. The recurrence rate was 18% (95% CI = 0.14–0.24, p = 0.015), and the rate of casting complications was 7% (95% CI = 0.03–0.15, p = 0.19). Conclusion: Application of the Ponseti method in children with untreated idiopathic clubfoot older than walking age leads to satisfactory outcomes, has a low cost, and avoids surgical procedures likely to cause complications. The results obtained exhibited considerable heterogeneity.https://doi.org/10.1177/2473011419S00409 |
| spellingShingle | Kelly Cristina Stéfani MD, PhD Davi de Podestá Haje MD, PhD Monica Paschoal Nogueira MD The Ponseti Method in Children with Clubfoot after Walking Age: Systematic Review and Metanalysis Foot & Ankle Orthopaedics |
| title | The Ponseti Method in Children with Clubfoot after Walking Age: Systematic Review and Metanalysis |
| title_full | The Ponseti Method in Children with Clubfoot after Walking Age: Systematic Review and Metanalysis |
| title_fullStr | The Ponseti Method in Children with Clubfoot after Walking Age: Systematic Review and Metanalysis |
| title_full_unstemmed | The Ponseti Method in Children with Clubfoot after Walking Age: Systematic Review and Metanalysis |
| title_short | The Ponseti Method in Children with Clubfoot after Walking Age: Systematic Review and Metanalysis |
| title_sort | ponseti method in children with clubfoot after walking age systematic review and metanalysis |
| url | https://doi.org/10.1177/2473011419S00409 |
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