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Physical Therapists Can Successfully Treat Clubfoot

Last Updated: May 06, 2009.

 

Once trained in the Ponseti method, they get better results than surgeons

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Physical therapists can use the Ponseti method to treat clubfoot as effectively as surgeons and their patients have fewer recurrences, according to a study published in the May issue of the Journal of Bone and Joint Surgery.

WEDNESDAY, May 6 (HealthDay News) -- Physical therapists can use the Ponseti method to treat clubfoot as effectively as surgeons and their patients have fewer recurrences, according to a study published in the May issue of the Journal of Bone and Joint Surgery.

Joseph A. Janicki, M.D., and colleagues at the Hospital for Sick Children in Toronto conducted a study of 120 children with 171 clubfeet, of whom 25 children with 34 clubfeet were treated by surgeons, while 95 children with 137 clubfeet were treated by a physical therapist. The children in both groups were similar in terms of age, treatment history and laterality of clubfoot, and the cohort was followed for at least two years after treatment.

The number of initial casts, Achilles tenotomy rate and failure rate were similar for both groups, but 26 percent of the patients in the surgeon-directed group required additional treatment for a recurrence versus 14 percent for those in the physical therapist-directed group, the investigators discovered. Repeat Achilles tenotomy or a limited posterior or posteromedial release were required by 6 percent of the physical therapist-directed group and 18 percent of the surgeon-directed group, the scientists noted.

"We believe that our physical therapist-run clubfoot clinic has been a successful model of effective delivery of quality care, without compromising outcomes," the authors write. "Such a model might allow the optimal and efficient use of surgeons' time while potentially improving the quality of care delivered and increasing patient satisfaction."

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