Article

In 2002-2003, several hospitals in Norway introduced the
Ponseti method for treating clubfoot. The present multicenter study was conducted
to evaluate the initial results of this method, and to compare them to the good
results reported in the literature. METHODS: 116 children with 162
congenital idiopathic clubfeet who were born between 2004 and 2006 were treated
with the Ponseti method at 8 hospitals in Norway.
All children were prospectively
registered at birth, and 116 feet were assessed according to Pirani before
treatment was started. 63% used a standard bilateral foot abduction brace, and
32% used a unilateral above-the-knee brace. One of the authors examined all feet
at a mean age of 4 years. At follow-up, all feet were assessed by Pirani's
scoring system, and range of motion of the foot and ankle was measured. RESULTS:
At follow-up, 77% of the feet had a Pirani score of 0.5 or better, good
dorsiflexion and external rotation, and no forefoot adduction. An Achilles
tenotomy had been performed in 79% of the feet. Compliance to any brace was good;
only 7% were defined as non-compliant. Extensive soft tissue release had been
performed in 3% of the feet. We found no statistically significant differences
between the two braces, except a tendency of better Pirani score in the group
using the bilateral foot abduction brace, and a tendency of better compliance in
patients using the unilateral brace. Better Pirani scores were found in children
who were treated at the largest hospitals. INTERPRETATION: After introducing the
Ponseti method in Norway, the clinical outcome was good and in accordance with
the reports from single centers. Only 5 feet needed extensive surgery during the
first 4 years of life.

Langue : ANGLAIS