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J Pediatr Orthop. 2005 Sep-Oct;25(5):627-9.

Results of manipulation of idiopathic clubfoot deformity in Malawi by

orthopaedic clinical officers using the Ponseti method: a realistic

alternative for the developing world?

Tindall AJ, Steinlechner CW, Lavy CB, Mannion S, Mkandawire N.

From BEIT Trust CURE International Hospital, Blantyre, Malawi.

This study looks at whether orthopaedic clinical officers, a cadre of

clinicians who are not doctors, can effectively manipulate idiopathic

clubfeet using the Ponseti technique. One hundred consecutive cases

of uncomplicated idiopathic clubfeet in newborn babies were

manipulated by orthopaedic clinical officers. Fifty-seven of these

were fully corrected to a plantigrade position by Ponseti

manipulation alone, and a further 41 were corrected by manipulation

followed by a simple percutaneous tenotomy. Orthopaedic clinical

officers therefore corrected 98 out of 100 feet; the remaining 2 feet

were referred for surgical correction. This shows that the Ponseti

method is suitable for use by nonmedical personnel in the developing

world to achieve a plantigrade foot.

PMID: 16199944 [PubMed - in process]

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