Journal of Orthopedic Nursing, Jan/Feb 2005

[Guest guest]

An interesting article in the January/February 2005 issue of the

Journal of Orthopedic Nursing called " Changing Paradigm for the

Treatment of Clubfeet " by e Faulks of the Texas ish Rite

Hospital and Luther of the Salt Lake City Shriners Hospital.

Orthopaedic Nursing

January/February 2005

Volume 24 Number 1

Pages 25 - 30

The abstract of the article says:

" Clubfoot is one of the most common pediatric orthopaedic

conditions. Until recently, surgical management was the treatment of

choice. Nonoperative treatment techniques, including the Ponseti

casting and French physical therapy methods, have peeked interest of

orthopaedists eager to find a less aggressive treatment method that

can assure a lasting, good result. Both methods have proven

successful in reducing the number of patients requiring extensive

surgical release and, as a result, have become an integral part of

pediatric orthopaedic practice. A clear understanding of both

treatment methods is important for the orthopaedic nurse to allow

quality nursing care and help assure a successful outcome for young

patients. "

Conclusion

" The Ponseti casting and French therapy methods of nonoperative

treatment for clubfoot have the potential to dramatically reduce the

number of extensive surgical releases performed and improve life-

long functional outcomes for this population. The changing paradigm

of clubfoot treatment requires pediatric orthopaedic nurses to be

familiar with both treatment methods and to understand their role in

ensuring successful outcomes for our patients and their families. "

The full article with photos can be seen at:

http://www.nursingcenter.com/library/journalarticleprint.asp?

Article_ID=542786

I beleive that Texas ish Rite uses both the French

Physiotherapy method and a somehow modified version of the Ponseti

method while the SLC Shriners only uses the Ponseti method. The

article does not point out that other recent Ponseti method studies

indicate that most are able to avoid the Posterior release surgery

for 90% or more of their patients. It still seems unusual that Texas

ish Rite reported at the 2003 POSNA meeting that their

experience with their version of the Ponseti method was able to

avoid the posterior release surgery only 60% of the time instead of

the 90+ % reported by all other groups. Texas ish Rite

reported that the patients treated with French Physiotherapy and

their version of the Ponseti method both were able to avoid the

posterior release types of surgery about 60% of the time.

and (3-17-99)

[Guest guest]

I take my son to Texas ish Rite to Dr. Rathjen. When we

first went, I was given the choice between the Ponseti and the French

method. I asked if one was more successful than the other. They

said they were currently doing studies, but that so far the success

rate was about the same at 80%. I guess it's gone up from 60% but I'd

rather see the 90%. Anyway, with the French method, instead of

casting there is intensive therapy by turning the foot out by

massaging all during the day. You also have to go over to ish

Rite every day at first for training, therapy and follow up which was

impossible for a working Mom like myself. It amazed me that they

have the same result without casting - it's just much more time and

labor intensive. Jake's feet were very severe (I didn't realize just

how severe until I saw some of the pics here), but they look really

great now, so hopefully his will be one of their successes - they

haven't even mentioned surgery and they cut him down to nights and

naps only in the DBB. I'm actually having him in them more hours

than what they instructed due to him being uncomfortable at night

after having them off all day. Some people on this site said they

thought his hours were cut too radically from 23/7 so I went back to

23/7 and he's doing great now so I'm going to gradually reduce down

to 18/7 - in regard to his hours I think they did wrong, but then

again Jake may be the exception or maybe that's their success rate

problem hmmmm....

>

> An interesting article in the January/February 2005 issue of the

> Journal of Orthopedic Nursing called " Changing Paradigm for the

> Treatment of Clubfeet " by e Faulks of the Texas ish Rite

> Hospital and Luther of the Salt Lake City Shriners Hospital.

>

> Orthopaedic Nursing

> January/February 2005

> Volume 24 Number 1

> Pages 25 - 30

>

> The abstract of the article says:

> " Clubfoot is one of the most common pediatric orthopaedic

> conditions. Until recently, surgical management was the treatment

of

> choice. Nonoperative treatment techniques, including the Ponseti

> casting and French physical therapy methods, have peeked interest

of

> orthopaedists eager to find a less aggressive treatment method that

> can assure a lasting, good result. Both methods have proven

> successful in reducing the number of patients requiring extensive

> surgical release and, as a result, have become an integral part of

> pediatric orthopaedic practice. A clear understanding of both

> treatment methods is important for the orthopaedic nurse to allow

> quality nursing care and help assure a successful outcome for young

> patients. "

>

> Conclusion

> " The Ponseti casting and French therapy methods of nonoperative

> treatment for clubfoot have the potential to dramatically reduce

the

> number of extensive surgical releases performed and improve life-

> long functional outcomes for this population. The changing paradigm

> of clubfoot treatment requires pediatric orthopaedic nurses to be

> familiar with both treatment methods and to understand their role

in

> ensuring successful outcomes for our patients and their families. "

>

> The full article with photos can be seen at:

> http://www.nursingcenter.com/library/journalarticleprint.asp?

> Article_ID=542786

>

> I beleive that Texas ish Rite uses both the French

> Physiotherapy method and a somehow modified version of the Ponseti

> method while the SLC Shriners only uses the Ponseti method. The

> article does not point out that other recent Ponseti method studies

> indicate that most are able to avoid the Posterior release surgery

> for 90% or more of their patients. It still seems unusual that

Texas

> ish Rite reported at the 2003 POSNA meeting that their

> experience with their version of the Ponseti method was able to

> avoid the posterior release surgery only 60% of the time instead of

> the 90+ % reported by all other groups. Texas ish Rite

> reported that the patients treated with French Physiotherapy and

> their version of the Ponseti method both were able to avoid the

> posterior release types of surgery about 60% of the time.

>

> and (3-17-99)