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Erschienen in:
01.12.2015 | Original Article
A knee-ankle-foot orthosis in treatment of talipes equino varus (TEV) with better patient compliance
Erschienen in: European Orthopaedics and Traumatology | Ausgabe 4/2015
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The Ponseti method for the treatment of clubfoot deformity gained worldwide popularity and became the standard of care in many medical centers due to its simplicity and high rate of success. Once the last cast has been removed, adherence to the brace protocol is crucial to prevent recurrence. Reports on failures with the Ponseti method have shown that the decisive factor that led to recurrence of the clubfoot deformity was non-compliance with the foot abduction brace protocol. The purpose of this study was to assess the results of a custom-made knee-ankle-foot brace after successful Ponseti method in terms of compliance and effectiveness in preventing recurrent clubfoot deformities.
Material and methods
Seventy-one idiopathic club feet treated successfully with Ponseti technique followed by a knee-ankle-foot orthosis with external rotation 70°. These patients are followed as regard brace compliance and effectiveness (recurrence of the deformity).
Results
Eight feet lost in the follow-up. The mean duration of follow-up was 52 months (range, 39–82 months). Non-compliance was not reported in any patients. The parents reported fully complied with the treatment instructions. The parents reported simplicity with bracing with no complications reported. Recurrent deformity requiring additional treatment occurred in 11 feet (17.46 %). Additional procedures included repeat tenotomy (nine patients) and limited posterior release with or without tendon transfers (two patients).
Conclusion
Our described orthosis provides simple, safe, and effective brace that is also comfortable for the child.