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Fewer Surgeries Performed for Idiopathic Clubfoot: Less Invasive Treatment Preferred
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Posted on: 04/21/2010
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Idiopathic clubfoot, a foot deformity from birth, does not alway need surgery for correction. For many years, doctors have been using a the Ponseti method of casting to manipulate the foot into a normal position, reducing the need for drastic surgery in many cases. This method was introduced in the 1950s. In the 1970s, surgery was a more popular option to treat clubfoot as surgeons felt that too many children relapsed when treated with the Ponseti method. Surgery was effective in the short-term, but many patients developed long-term foot pain, disability, stiffness and weakness. In the 1990s, surgeons began looking at the Ponseti method again and found encouraging results, particularly after the treatment was refined. The authors of this article reviewed the effectiveness and outcomes of the Ponseti method and if surgery decreased as a result.
Researchers reviewed the annual number of live births for the duration of the study (from 1996 to 2006). Of the live births, the researchers obtained annual statistics of clubfoot. The number of infants with clubfoot varied from 0.60 per 1,000 births in 1996 to 0.46 per 1,000 births in 2006. There was no gradual decline or increase by year.
In 1996, there were 2,281 diagnosis of clubfoot, 1,641 were repaired by surgery, for a 0.72 rate of procedure. In 1997, that raised slightly to 0.72, but then dropped to 0.56 in 1998. This was followed by a jump for two years, and then drops down to 0.12 in 2006 - 230 surgical procedures on 1,974 clubfeet.
The authors concluded that the rate of surgery for clubfoot was definitely decreasing over time and, in their opinion, this decline will continue as doctors work on less invasive treatments, such as the Ponseti method, with more refining over time.
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References:
Lewis E. Zionts, MD, et a. Has the Rate of Extensive Surgery to Treat Idiopathic Clubfoot Declined in the United States? In The Journal of Bone & Joint Surgery. Feb. 2010. Vol. 92. No. 4. Pp. 882-889.
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