Bracing in the treatment of children with clubfoot: past, present, and future.
Bracing is a critical component of the current standard of treatment for clubfoot. Adherence to the bracing protocol is the main factor for the long-term success of the treatment The purpose of this paper is to provide a review of clubfoot braces, best practices in brace design and recommendations for bracing in order to improve adherence with the bracing phase of the clubfoot treatment. There are a number of designs and offerings of braces available in various regions of the world. Although many new brace designs are being proposed and developed, evidence in the literature regarding biomechanical effects, clinical outcomes, functionality and patient adherence is limited. The current research that is available regarding brace design focuses on increasing patient comfort and satisfaction to improve adherence. Although the currently available braces are widely distributed in developed countries, access is limited to many parts of the world. When considering the future of the clubfoot treatment and prevention of relapses, since 80% of the cases are in developing countries with limited resources, brace cost and availability needs to be assessed.
Joint Department of Biomedical Engineering, North Carolina State University and The University of North Carolina at Chapel Hill Chapel Hill, North Carolina, USA.
Lajja
L
Desai
Florin
F
Oprescu
Andrew
A
DiMeo
Jose A
JA
Morcuende
D001696:Biomechanical Phenomena; D001915:Braces / Q000191:economics / Q000639:trends*; D003025:Clubfoot / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D010349:Patient Compliance; D016896:Treatment Outcome