Clubfoot Cast Simulation Using Pressure Sensors: A Novel Way to Teach the Ponseti Method.

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Abstract

[Indexed for MEDLINE] 16. Int Orthop. 2018 Oct;42(10):2437-2442. doi: 10.1007/s00264-018-3934-7. Epub 2018 May 7. Joint hyperlaxity prevents relapses in clubfeet treated by Ponseti method-preliminary results. Cosma DI(1), Corbu A(1), Nistor DV(1), Todor A(1), Valeanu M(2), Morcuende J(3), Man S(4). Author information: (1)Department of Orthopaedics, Traumatology and Paediatric Orthopaedics, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania. (2)Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy "Iuliu Hatieganu", 6 Pasteur st, Cluj-Napoca, Romania. mvaleanu@umfcluj.ro. (3)Carver College of Medicine, University of Iowa, Iowa City, IA, USA. (4)Department of Paediatrics, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania. PURPOSE: The aim of the study was to evaluate the role of joint hyperlaxity (by Beighton score) as a protective factor for clubfoot relapse. METHODS: Patients with idiopathic clubfoot treated with the Ponseti method between January 2004 and December 2012, without other congenital foot deformity, and not previously treated by open surgery were included in either the Relapse group (n = 23) if it was a clubfoot relapse or the Control group (n = 19) if no relapse was noted. Joint laxity was evaluated using the Beighton score at the latest follow-up against the Normal group (n = 22, children matched by sex and age without clubfoot deformity). RESULTS: We found a significantly higher joint laxity in the Control group (4.58, 95% confidence interval [CI]: 2.1-7.06) as compared to the Relapse (3.17, 95% CI: 1.53-4.81, p = 0.032) and Normal (3.14, 95% CI: 1.78-4.5, p = 0.03) groups. The univariate logistic regression showed a 5.28-times increase in the risk of relapse for a Beighton score lower than 4/9 points (odds ratio = 5.28; 95% CI = 1.29-21.5; p = 0.018). CONCLUSIONS: Joint hyperlaxity could be a protective factor for clubfoot relapse. DOI: 10.1007/s00264-018-3934-7