Dallas ish Rite Hospital

[Guest guest]

An interesting article on Texas ish Rite Hospital in Dallas and

their use of a French Phsyiotherapy method as well as their version

of the Ponseti method. But some of the quotes don't seem quite

right or accurate. Some excerpts from the article follows. [MY

COMMENTS ARE IN CAPITALS]

" The hospital began offering the French technique in 1996, but

because of the lengthy time commitment required, many parents still

choose the traditional Ponseti method, s said. " [THIS IS THE

FIRST TIME THAT I HAVE EVER SEEN THE PONSETI METHOD DESCRIBED AS THE

TRADITIONAL METHOD OF TREATMENT. DALLAS DID NOT START USING THEIR

VERSION OF THE PONSETI METHOD UNTIL ABOUT 2001]

Developed by Dr. Ignacio Ponseti, the technique uses a series of

complete leg castings once a week for several weeks or months until

the feet are corrected. The child also usually wears a bar

connecting his or her shoes for 23 hours a day for the next few

years. [THE DESCRIPTION OF THE PONSETI METHOD NEEDING SHOES AND BAR

FOR 23 HOURS A DAY FOR YEARS IS OBVIOUSLY NOT ACCURATE]

With both methods, minor surgery to stretch the heel cord is

sometimes required. Between the two methods, however, doctors at

ish Rite Hospital have reduced the need for major surgery by

more than 60 percent. [THE LAST REPORT I HAD SEEN INDICATED THAT

TEXAS SCOTTISH RITE'S RATES OF " NON-SURGICAL " SUCCESS FOR THEIR

VERSIONS OF THE FRENCH AND PONSETI METHODS WERE ABOUT THE SAME AT

ABOUT 50% NOT NEEDING POSTERIOR RELEASE TYPES OF SURGERY. AS MANY

DIFFERENT RECENT PONSETI METHOD STUDIES HAVE INDICATED, FOLLOWING

THE PONSETI METHOD EXACTLY AS DESIGNED SHOULD RESULT IN AT LEAST 90%

AND PROBABLY MORE THAN 95% NOT NEEDING POSTERIOR RELEASE TYPES OF

SURGERY.]

http://www.bradenton.com/mld/bradenton/news/nation/10562317.htm

A study just published in the Jan 2005 issue of the Journal of

Pediatric Orthopedics by Texas ish Rite in Dallas indicated

that they had 49% who needed posterior release or posterio-medial

release types of surgery when using the French Physiotherapy

method. But they did avoid tenotomies for 40% versus 15% in the

Ponseti method.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15614069

At the 2002 POSNA convention in Salt Lake City during a discussion

of the Ponseti and French methods, it was mentioned that the U of

Iowa studies included a few children who had started out with French

Physiotherpay and were heading for surgery at about 11 months of

age. The parents then went to Iowa where the Ponseti method was

able to successfully avoid the surgery. I had reported that in a

message about that meeting back in May of 2002 as follows:

" At the beginning of the discussion, one doctor in the audience stood

up and asked Dr. s of ish Rite that based on the

presentations of today, that perhaps if by 12 months, the French

method was not being successful, that before going forward with the

surgery that perhaps they could then still send the child to Iowa or

to Dr. Herzenberg for the Ponseti method (which) had been shown to be

successful up to 16 months. "

http://health.groups.yahoo.com/group/nosurgery4clubfoot/message/11030

[Guest guest]

The same article was also in the Dallas Morning News on December 28,

2004.

http://www.dallasnews.com/sharedcontent/dws/news/localnews/stories/12

2804dnmetclubfoot.40745.html

At the 2004 POSNA Convention, Texas presented a study comparing

their versions of the French and Ponseti methods. It was called a

Prospective Study of Idiopathic Clubfeet Comparing the Ponseti and

French PT Methods - Early Results

B s, MD (n); C E ston, MD (n); S Faulks (n); H

(n)

In that study, they indicated that their non-surgical success (not

using posterior releases) with the Ponseti method was about 50-60%.

That was about the same degree of non-surgical success as they had

with the French Physiotherapy.

>

> An interesting article on Texas ish Rite Hospital in Dallas

and

> their use of a French Phsyiotherapy method as well as their

version

> of the Ponseti method. But some of the quotes don't seem quite

> right or accurate. Some excerpts from the article follows. [MY

> COMMENTS ARE IN CAPITALS]

>

> " The hospital began offering the French technique in 1996, but

> because of the lengthy time commitment required, many parents

still

> choose the traditional Ponseti method, s said. " [THIS IS

THE

> FIRST TIME THAT I HAVE EVER SEEN THE PONSETI METHOD DESCRIBED AS

THE

> TRADITIONAL METHOD OF TREATMENT. DALLAS DID NOT START USING THEIR

> VERSION OF THE PONSETI METHOD UNTIL ABOUT 2001]

>

> Developed by Dr. Ignacio Ponseti, the technique uses a series of

> complete leg castings once a week for several weeks or months

until

> the feet are corrected. The child also usually wears a bar

> connecting his or her shoes for 23 hours a day for the next few

> years. [THE DESCRIPTION OF THE PONSETI METHOD NEEDING SHOES AND

BAR

> FOR 23 HOURS A DAY FOR YEARS IS OBVIOUSLY NOT ACCURATE]

>

> With both methods, minor surgery to stretch the heel cord is

> sometimes required. Between the two methods, however, doctors at

> ish Rite Hospital have reduced the need for major surgery by

> more than 60 percent. [THE LAST REPORT I HAD SEEN INDICATED THAT

> TEXAS SCOTTISH RITE'S RATES OF " NON-SURGICAL " SUCCESS FOR THEIR

> VERSIONS OF THE FRENCH AND PONSETI METHODS WERE ABOUT THE SAME AT

> ABOUT 50% NOT NEEDING POSTERIOR RELEASE TYPES OF SURGERY. AS MANY

> DIFFERENT RECENT PONSETI METHOD STUDIES HAVE INDICATED, FOLLOWING

> THE PONSETI METHOD EXACTLY AS DESIGNED SHOULD RESULT IN AT LEAST

90%

> AND PROBABLY MORE THAN 95% NOT NEEDING POSTERIOR RELEASE TYPES OF

> SURGERY.]

> http://www.bradenton.com/mld/bradenton/news/nation/10562317.htm

>

> A study just published in the Jan 2005 issue of the Journal of

> Pediatric Orthopedics by Texas ish Rite in Dallas indicated

> that they had 49% who needed posterior release or posterio-medial

> release types of surgery when using the French Physiotherapy

> method. But they did avoid tenotomies for 40% versus 15% in the

> Ponseti method.

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

> cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15614069

>

> At the 2002 POSNA convention in Salt Lake City during a discussion

> of the Ponseti and French methods, it was mentioned that the U of

> Iowa studies included a few children who had started out with

French

> Physiotherpay and were heading for surgery at about 11 months of

> age. The parents then went to Iowa where the Ponseti method was

> able to successfully avoid the surgery. I had reported that in a

> message about that meeting back in May of 2002 as follows:

>

> " At the beginning of the discussion, one doctor in the audience

stood

> up and asked Dr. s of ish Rite that based on the

> presentations of today, that perhaps if by 12 months, the French

> method was not being successful, that before going forward with the

> surgery that perhaps they could then still send the child to Iowa

or

> to Dr. Herzenberg for the Ponseti method (which) had been shown to

be

> successful up to 16 months. "

>

http://health.groups.yahoo.com/group/nosurgery4clubfoot/message/11030

>

>