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The Bone & Joint Journal
Vol. 104-B, Issue 6 | Pages 758 - 764
1 Jun 2022
Attaining a British consensus on managing idiopathic congenital talipes equinovarus up to walking age
Gelfer Y Davis N Blanco J Buckingham R Trees A Mavrotas J Tennant S Theologis T
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Aims

The aim of this study was to gain an agreement on the management of idiopathic congenital talipes equinovarus (CTEV) up to walking age in order to provide a benchmark for practitioners and guide consistent, high-quality care for children with CTEV.

Methods

The consensus process followed an established Delphi approach with a predetermined degree of agreement. The process included the following steps: establishing a steering group; steering group meetings, generating statements, and checking them against the literature; a two-round Delphi survey; and final consensus meeting. The steering group members and Delphi survey participants were all British Society of Children’s Orthopaedic Surgery (BSCOS) members. Descriptive statistics were used for analysis of the Delphi survey results. The Appraisal of Guidelines for Research & Evaluation checklist was followed for reporting of the results.

The Bone & Joint Journal
Vol. 100-B, Issue 12 | Pages 1655 - 1660
1 Dec 2018
Rapid decrease of cast-induced forces during the treatment of clubfoot using the Ponseti method
Giesberts RB G. Hekman EE Verkerke GJ M. Maathuis PG
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Aims

The Ponseti method is an effective evidence-based treatment for clubfoot. It uses gentle manipulation to adjust the position of the foot in serial treatments towards a more physiological position. Casting is used to hold the newly achieved position. At first, the foot resists the new position imposed by the plaster cast, pressing against the cast, but over time the tissues are expected to adapt to the new position and the force decreases. The aim of this study was to test this hypothesis by measuring the forces between a clubfoot and the cast during treatment with the Ponseti method.

Patients and Methods

Force measurements were made during the treatment of ten idiopathic clubfeet. The mean age of the patients was seven days (2 to 30); there were nine boys and one girl. Force data were collected for several weeks at the location of the first metatarsal and the talar neck to determine the adaptation rate of the clubfoot.

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