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https://www.readbyqxmd.com/read/28328564/variation-in-national-acgme-case-log-data-for-pediatric-orthopaedic-fellowships-are-fellow-coding-practices-responsible
#1
Philip K McClure, Marcella Woiczik, Lori Karol, Wudbhav N Sankar
BACKGROUND: The introduction of the 80-hour work week for Accreditation Council for Graduate Medical Education (ACGME) accredited fellowship programs initiated many efforts to optimize surgical training. One particular area of interest is on recording and tracking surgical experiences. The current standard is logging cases based on Current Procedural Terminology codes, which are primarily designed for billing. Proposed guidelines from the ACGME regarding logging exist, but their implementation is unknown, as is the variation in case volume across fellowship programs...
March 21, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28296659/modified-ponseti-technique-for-management-of-neglected-clubfeet
#2
Anil Mehtani, Jatin Prakash, Vipul Vijay, Nishikant Kumar, Abhinav Sinha
Achieving adequate dorsiflexion in neglected clubfoot cases remains challenging. On a close observation of the Ponseti method, we have now made certain modifications from the standard Ponseti protocol. This has helped us improve functional results, as well as reduce the number of casts in this walking-age group. From March 2011 onward, we managed 62 neglected clubfeet in 41 patients with the modified protocol. All these patients were treated with serial weekly above-knee casts. The feet were assessed by Dimeglio and Pirani scorings, which were done every week...
March 14, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28266239/guideline-on-the-diagnosis-and-treatment-of-primary-idiopathic-clubfoot
#3
Arnold T Besselaar, Ralph J B Sakkers, Hans A Schuppers, Melinda M E H Witbreuk, Elgun V C M Zeegers, Jan D Visser, Robert A Boekestijn, Sacha D Margés, M C Marieke Van der Steen, Koert N J Burger
- A delegation of 6 pediatric orthopedic surgeons from the Dutch Orthopedic Association (NOV) and 2 members of the board of the Dutch Parents' Association for children with clubfoot created the guideline "The diagnosis and treatment of primary idiopathic clubfeet" between April 2011 and February 2014. The development of the guideline was supported by a professional methodologist from the Dutch Knowledge Institute of Medical Specialists. This evidence-based guideline process was new and unique, in the sense that the process was initiated by a parents' association...
March 7, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28248538/possible-pathogenetic-mechanisms-and-new-therapeutic-approaches-of-pes-equinovarus
#4
M Ošťádal, J Lišková, D Hadraba, A Eckhardt
Idiopathic pes equinovarus (clubfoot) is a congenital deformity of the foot and lower leg defined as a fixation of the foot in plantar flexion, adduction, supination and varus. The deformity does not affect only the foot position, which is usually investigated by radiography, CT, micro-CT, MRI or ultrasound but logically influence the whole gait biomechanics. It is supposed, that clubfoot belongs to a group of fibroproliferative disorders whose origin and multi-hierarchical effect remain unknown. It has been suggested that fibroblasts and growth factors may be involved...
February 28, 2017: Physiological Research
https://www.readbyqxmd.com/read/28240726/gross-motor-skills-in-children-with-idiopathic-clubfoot-and-the-association-between-gross-motor-skills-foot-involvement-gait-and-foot-motion
#5
Elin Lööf, Hanneke Andriesse, Marie André, Stephanie Böhm, Maura D Iversen, Eva W Broström
BACKGROUND: Little is known regarding gross motor skills (GMS) in children with idiopathic clubfoot (IC). This study describes GMS, specifically foot involvement and asymmetries, and analyses the association between GMS, gait, and foot status in children with IC. METHODS: Gross motor tasks and gait were analyzed in children with IC and typically developed (TD) children. GMS were assessed using videotapes and the Clubfoot Assessment Protocol (CAP). The Gait Deviation Index (GDI) and GDI-Kinetic were calculated from gait analyses...
February 24, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28240717/pain-and-overcorrection-in-clubfeet-treated-by-ponseti-method
#6
Christopher B Hayes, Kevin A Murr, Ryan D Muchow, Henry J Iwinski, Vishwas R Talwalkar, Janet L Walker, Todd A Milbrandt, Pooya Hosseinzadeh
Long-term outcomes of Ponseti casting have consistently shown improvement over soft-tissue release. The incidence of foot pain and overcorrection in clubfeet treated by Ponseti method has not been reported. We studied the rate of overcorrection and its association with pain in clubfeet treated with Ponseti casting. A retrospective review of clubfoot patients treated with Ponseti method with at least 8 years of follow-up was carried out. Patient charts were reviewed for demographic data, recurrence, type and number of procedures, and patient-reported complaints of foot pain...
February 24, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28236079/the-2017-abjs-nicolas-andry-award-advancing-personalized-medicine-for-clubfoot-through-translational-research
#7
Matthew B Dobbs, Christina A Gurnett
BACKGROUND: Clubfoot is one of the most common pediatric orthopaedic disorders. While the Ponseti method has revolutionized clubfoot treatment, it is not effective for all patients. When the Ponseti method does not correct the foot, patients are at risk for lifelong disability and may require more-extensive surgery. QUESTIONS/PURPOSES: (1) What genetic and morphologic abnormalities contribute to the development of clubfoot? (2) How can this information be used to devise personalized treatment paradigms for patients with clubfoot? METHODS: Human gene sequencing, molecular genetic engineering of mouse models of clubfoot, MRI of clubfoot, and development of new treatment methods all have been used by our group to understand the biological basis and improve therapy for this group of disorders...
February 24, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28216755/interobserver-variability-in-pirani-clubfoot-severity-scoring-system-between-the-orthopedic-surgeons
#8
Saurabh Jain, Anand Ajmera, Mahendra Solanki, Alok Verma
BACKGROUND: Congenital talipes equinovarus (clubfoot) is one of the most common congenital pediatric orthopedic foot deformity, which varies in severity and clinical course. Assessment of severity of the club foot deformity is essential to assess the initial severity of deformity, to monitor the progress of treatment, to prognosticate, and to identify early relapse. Pirani's scoring system is most acceptable and popular for club foot deformity assessment because it is simple, quick, cost effective, and easy...
January 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28195983/management-of-the-relapsed-clubfoot-following-treatment-using-the-ponseti-method
#9
Pooya Hosseinzadeh, Derek M Kelly, Lewis E Zionts
The Ponseti method to treat idiopathic clubfoot deformity has proven to be reliable, and several centers have reported excellent outcomes. Although the method has been dependable in obtaining initial correction of the foot, relapse rates ranging from 26% to 48% have been reported. When a relapsed deformity is detected early, treatment with a short series of manipulations and cast applications followed by resumption of postcorrective bracing may be all that is required to regain and maintain correction. In patients aged >2...
March 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28178095/clubfoot-and-tethered-cord-syndrome-results-of-treatment-with-the-ponseti-method
#10
Trevor Jackson, Alexander Jones, Nancy Miller, Gaia Georgopoulos
BACKGROUND: The Ponseti technique has demonstrated high success rates worldwide for the treatment of idiopathic clubfoot. The purpose of this study was to determine whether clubfoot associated with tethered cord syndrome (TCS) was more resistant to Ponseti treatment than isolated clubfoot. METHODS: An IRB-approved retrospective cohort study of subjects undergoing Ponseti treatment of clubfoot between 2002 and 2013 was conducted. Subjects with TCS were matched to subjects with isolated clubfoot (1:2) on the basis of laterality, date of birth, sex, and age at presentation...
February 7, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28178093/management-of-clubfoot-relapses-with-the-ponseti-method-results-of-a-survey-of-the-posna-members
#11
Pooya Hosseinzadeh, Gary M Kiebzak, Lori Dolan, Lewis E Zionts, Jose Morcuende
BACKGROUND: Despite the high rate of initial success using the Ponseti method to manage idiopathic clubfoot deformity, relapse continues to be a problem. We surveyed the Pediatric Orthopedic Society of North America (POSNA) members about their experience with relapsed deformity following the initial correction of clubfeet. METHODS: We created a survey to focus on the management of clubfeet after initial correction of deformity. The survey included questions on postcorrective bracing, clinical findings used to identify relapse, the observed frequency of relapsed deformity, and how relapses are managed...
February 7, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28157574/anatomical-masking-of-pressure-footprints-based-on-the-oxford-foot-model-validation-and-clinical-relevance
#12
Claudia Giacomozzi, Julie A Stebbins
Plantar pressure analysis is widely used in the assessment of foot function. In order to assess regional loading, a mask is applied to the footprint to sub-divide it into regions of interest (ROIs). The most common masking method is based on geometric features of the footprint (GM). Footprint masking based on anatomical landmarks of the foot has been implemented more recently, and involves the integration of a 3D motion capture system, plantar pressure measurement device, and a multi-segment foot model. However, thorough validation of anatomical masking (AM) using pathological footprints has not yet been presented...
December 23, 2016: Gait & Posture
https://www.readbyqxmd.com/read/28118804/the-foot-abduction-characteristics-following-steenbeek-foot-abduction-brace
#13
Anil Agarwal, Anubrat Kumar, Madhusudan Mishra
PURPOSE: We prospectively investigated the foot abduction characteristics following Steenbeek foot abduction brace (SFAB) use in corrected clubfeet. The foot abduction achievable in SFAB with knee flexion and extension was calculated to find the effectiveness and stretch exerted by it. METHODS: Only children with corrected idiopathic clubfeet using SFAB for greater than 3 months were enrolled. The foot abduction with and without brace in knee extended and flexed positions was measured...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28118300/early-application-of-the-ponseti-casting-technique-for-clubfoot-correction-in-sick-infants-at-the-neonatal-intensive-care-unit
#14
Ehud Lebel, Eliraz Weinberg, Tamar M Berenstein-Weyel, Ruben Bromiker
The treatment of congenital clubfoot has been changing rapidly since the mid-1990s with the worldwide use of the Ponseti method for serial casting and limited operative interventions. This method was first applied for isolated clubfeet and later on for other types of clubfoot (teratologic, residual, and neurogenic). Premature babies sustaining clubfoot commonly suffer from additional congenital and acquired medical problems. These may postpone clubfoot management until urgent issues are resolved. The current study describes early initiation of treatment of clubfoot in premature babies at the neonatal intensive care unit (NICU) and their outcomes...
March 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28114267/the-clubfoot-over-the-centuries
#15
Ilaria Sanzarello, Matteo Nanni, Cesare Faldini
The aim of this paper is to review all treatment methods of the clubfoot over the years through the documentation present in the literature and art with the aim of better understanding the pathoanatomy of the deformity, but to also clarify factors that allow a safe, logical approach to clubfoot management. The initial part of this paper traces the most representative iconographic representations of clubfoot in history to describe how his presence was witnessed since ancient times. Hippocrates, the father of medicine, was the first to present written references about treatment methods of clubfoot...
March 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28099306/nonoperatively-corrected-clubfoot-at-age-2-years-radiographs-are-not-helpful-in-predicting-future-relapse
#16
B Stephens Richards, Shawne Faulks, Ozan Razi, Amanda Moualeu, Chan-Hee Jo
BACKGROUND: Nonoperative treatment of idiopathic clubfoot is standard. The purpose of this study was to determine if measurements made on standing lateral radiographs of successfully treated clubfeet made at 18 to 24 months of age were predictive of late recurrence. METHODS: Inclusion criteria were idiopathic clubfoot with an age at presentation of ≤3 months, nonoperative treatment resulting in a clinically plantigrade foot at 2 years of age, standing lateral radiograph of the involved foot made at 18 to 24 months of age, and a minimum age of 4 years at the time of follow-up...
January 18, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28079742/the-hybrid-method-for-the-treatment-of-congenital-talipes-equinovarus-preliminary-results-on-92-consecutive-feet
#17
Federico Canavese, Mounira Mansour, Guillemette Moreau-Pernet, Yannael Gorce, Alain Dimeglio
Over the past 4 years, our pediatric orthopedic unit has developed a new hybrid protocol combining the advantages of Ponseti's method and the French functional physiotherapy method. Sixty-one patients (92 feet) completed treatment. Clubfoot was unilateral in 30 (49.2%) patients and bilateral in 31 (50.8%) patients. The mean Dimeglio score at the start of treatment was 13.5/20 (range: 6/20-19/20). All patients had clinical and radiographic follow-up for at least 2 years (range: 2-4 years). If orthopedic treatment was ineffective and feet showed no improvement, further surgery was performed...
January 10, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28053270/the-quality-of-achilles-tendon-repair-five-to-eight-years-after-percutaneous-tenotomy-in-the-treatment-of-clubfoot-clinical-and-ultrasonographic-findings
#18
D A Maranho, F H L Leonardo, C F Herrero, E E Engel, J B Volpon, M H Nogueira-Barbosa
AIMS: Our aim was to describe the mid-term appearances of the repair process of the Achilles tendon after tenotomy in children with a clubfoot treated using the Ponseti method. PATIENTS AND METHODS: A total of 15 children (ten boys, five girls) with idiopathic clubfoot were evaluated at a mean of 6.8 years (5.4 to 8.1) after complete percutaneous division of the Achilles tendon. The contour and subjective thickness of the tendon were recorded, and superficial defects and its strength were assessed clinically...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28050536/functional-and-clinical-results-achieved-in-congenital-clubfoot-patients-treated-by-ponseti-s-technique
#19
Pedro Augusto Jaqueto, Guilherme Salgado Martins, Fernando Saddi Mennucci, Cintia Kelly Bittar, José Luís Amim Zabeu
OBJECTIVES: To analyze and evaluate functional and clinical results in patients with congenital clubfoot treated with Ponseti's technique. METHODS: This study evaluated 31 patients diagnosed with 51 congenital clubfeet, treated between April 2006 and September 2011 with Ponseti's technique. The patients who did not achieve an equinus correction with manipulation were treated with Achilles tenotomy. An anterior tibial tendon transfer was performed in patients who maintained residual adduction...
November 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28000394/birth-prevalence-of-congenital-talipes-equinovarus-in-low-and-middle-income-countries-a-systematic-review-and-meta-analysis
#20
REVIEW
Tracey Smythe, Hannah Kuper, David Macleod, Allen Foster, Christopher Lavy
OBJECTIVE: Congenital talipes equinovarus (CTEV), or clubfoot, is a structural malformation that develops early in gestation. Birth prevalence of clubfoot is reported to vary both between and within low- and middle-income countries (LMICs), and this information is needed to plan treatment services. This systematic review aimed to understand the birth prevalence of clubfoot in LMIC settings. METHODS: Six databases were searched for studies that reported birth prevalence of clubfoot in LMICs...
December 21, 2016: Tropical Medicine & International Health: TM & IH
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