title: Ponseti method: does age at the beginning of treatment make a difference?
abstract: The Ponseti method is reportedly effective for treating clubfoot in children up to 9 years of age. However, whether age at the beginning of treatment influences the rate of successful correction and the rate of relapse is unknown. We therefore retrospectively reviewed 68 consecutive children with 102 idiopathic clubfeet treated by the Ponseti technique in four Portuguese hospitals. We followed patients a minimum of 30 months (mean, 41.4 months; range, 30-61 months). The patients were divided into two groups according to their age at the beginning of treatment; Group I was younger than 6 months and Group II was older than 6 months. All feet (100%) were initially corrected and no feet required extensive surgery regardless of age at the beginning of treatment. There were no differences between Groups I and II in the number of casts, tenotomies, success in terms of rate of initial correction, rate of recurrence, and rate of tibialis anterior transference. The rate of the Ponseti method in avoiding extensive surgery was 100% in Groups I and II; relapses occurred in 8% of the feet in younger and older children.
  
  
  METHODS
  Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopaedics, Hospital Central do Funchal, Av Luis Camões, 9000-514, Funchal, Portugal. cristina37003@hotmail.com
authors.forename: Cristina
authors.initials: C
authors.lastname: Alves
authors.forename: Carolina
authors.initials: C
authors.lastname: Escalda
authors.forename: Pedro
authors.initials: P
authors.lastname: Fernandes
authors.forename: Delfin
authors.initials: D
authors.lastname: Tavares
authors.forename: M Cassiano
authors.initials: MC
authors.lastname: Neves
mesh_terms: D000125:Achilles Tendon / Q000601:surgery*; D000367:Age Factors; D001915:Braces; D002370:Casts, Surgical; D002675:Child, Preschool; D003025:Clubfoot / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D026201:Musculoskeletal Manipulations; D011174:Portugal; D012008:Recurrence; D012189:Retrospective Studies; D013709:Tendon Transfer; D013997:Time Factors; D016896:Treatment Outcome