Online Questions About Clubfoot Surgery: Content Analysis and Development of a Patient Education Resource

Clubfoot affects approximately 2 in 1,000 newborns globally. The Ponseti Method, the standard method of casting and bracing, often ends with Achilles tenotomy. More invasive procedures, such as posteromedial release, are typically reserved for complex or recurrent cases. Prior studies indicate that parents frequently turn to the internet to understand clubfoot treatments, though no studies have examined specific questions or the credibility of websites. This study identifies the most common online questions about clubfoot surgeries, assesses the credibility and types of sources answering them, and offers a handout of suggested resources.

We extracted 1,207 question-website pairs from Google's "People Also Ask" feature using keywords on clubfoot surgeries. Questions were categorized using Rothwell's Classification System. Websites were evaluated for credibility using the Journal of the American Medical Association (JAMA) Benchmark Criteria.

A total of 992 question-website pairs were included for analysis. Most questions were fact-based (68.1%), focusing on technical details (49.2%), risks (13.2%), and recovery (10.3%). Academic websites were most frequent (55.9%). Sources were moderately credible (mean JAMA score = 1.79). Private medical practices, often linked to queries about percutaneous options, displayed the lowest credibility (mean JAMA score = 0.5).

Most online queries about clubfoot surgery focus on procedural details, risks, and recovery, reflecting the specific concerns that families seek to address when considering treatment. The high repetition of websites lacking high credibility and showing limited diversity of search results suggests a gap in accessible, comprehensive online resources. Our findings emphasize the need for clinician awareness of this digital landscape and for proactive educational strategies. To help address this, we developed a curated, patient-facing handout that can be used to link families to credible sources, support informed decision-making, and enhance communication between parents and pediatric orthopaedic surgeons.

(1)Parents frequently search online for information about clubfoot surgeries, with questions most often focused on procedural details, risks, and recovery.(2)The majority of responses come from academic websites, though overall online credibility is variable, with important differences across source types.(3)Queries about posteromedial release emphasize technical details, while percutaneous procedures prompt more questions about risks, recovery, and outcomes.(4)The limited diversity and variable credibility of commonly accessed online resources highlight the need for more accessible, trustworthy educational content for families.(5)A curated, patient-facing handout linking families to reliable resources can support informed decision-making and enhance communication between caregivers and pediatric orthopaedic surgeons.

IV.