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Gait kinetics in children with clubfeet treated surgically or with the Ponseti method: A meta-analysis

A B M Tuinsma1, B Vanwanseele2, L van Oorschot3

  • 1Department of Orthopaedic Surgery, Catharina Hospital Eindhoven, Postbus 1350, 5602 ZA, Eindhoven, The Netherlands.

Gait & Posture
|September 1, 2018
PubMed

Insights

Children treated for clubfeet using the Ponseti method show altered gait kinetics, specifically lower ankle power and plantarflexor moment compared to healthy peers. Surgical versus Ponseti treatment showed no significant gait differences.

Area of Science:

  • Orthopedics
  • Biomechanics
  • Pediatric care

Background:

  • The Ponseti method is the standard treatment for clubfeet.
  • Gait analysis is crucial for long-term functional evaluation of clubfoot treatments.
  • Previous research has identified gait discrepancies between treated clubfeet and healthy individuals.

Purpose of the Study:

  • To systematically compare gait kinetics in clubfeet treated with the Ponseti method against healthy controls.
  • To compare gait kinetics between clubfeet treated surgically versus those treated with the Ponseti method.

Main Methods:

  • A comprehensive systematic search was conducted across multiple databases (Embase, Medline Ovid, Web of Science, Scopus, Cochrane, Cinahl ebsco, Google Scholar).
  • Studies focusing on gait kinetics in children with clubfeet treated via the Ponseti method were included, excluding those solely using EMG or pedobarography.
  • Data extraction and risk of bias assessment were performed, followed by meta-analyses and qualitative analyses.

Main Results:

  • Five of nine included studies were part of the meta-analyses.
  • Ponseti-treated clubfeet exhibited significantly lower ankle plantarflexor moment and ankle power compared to healthy controls.
  • No significant differences in ankle moments or power were observed between surgically treated clubfeet and those treated with the Ponseti method.

Conclusions:

  • Gait kinetics differ between Ponseti-treated clubfeet and healthy individuals.
  • There are no significant gait kinetic differences between surgical and Ponseti treatments for clubfeet.
  • Findings offer insights for improving gait patterns in patients with clubfeet.
Abstract

Keywords:
ClubfootFunctional outcomeKineticsPonseti methodSurgical treatment

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