title: Ponseti Brasil: a national program to eradicate neglected clubfoot - preliminary results.
abstract: BACKGROUND
  After hearing about the reproducible and excellent results of the Ponseti method for clubfoot treatment, a group of Brazilian orthopaedic surgeons organized and participated in a standardized national program to teach the Ponseti technique in 21 different cities across Brazil.
  
  
  METHODS
  A total of 21 Ponseti symposiums were organized in a standard fashion from January, 2007 to December, 2008. They consisted of a two-day program with lectures, hands-on cast application, and discussion of local clinical cases presented by orthopaedic surgeons. Thirteen Brazilian orthopaedic surgeons, who had been trained by the University of Iowa or centers recognized by them, taught the method. Financial support for travel was provided by an English charity: La Vida (Vital Investment for Developing Aid in Latin America). The physicians who attended the symposiums answered questionnaires before and after the training.
  
  
  RESULTS
  About 7% of the 8000 orthopaedic surgeons in Brazil (556 orthopaedic surgeons) were trained. These orthopaedic surgeons stated that they had treated about 4905 babies in the previous year via other methods, including extensive surgery. Seventeen percent of the surgeons did not know about the Ponseti technique at the start of the symposium. Eighty-eight percent reported they felt able to treat children with the Ponseti technique after the symposium. Ninety-four percent of respondents reported that the symposium changed their way of treating clubfoot
  
  
  CONCLUSIONS
  These Ponseti symposiums brought about an exchange of medical information and empowered the participants. This program is a good educational tool which can be used in eradicating neglected clubfoot in Brazil.
authors.affiliation: Faculdade de Saúde Publica - USP, São Paulo, Brazil. monipn@uol.com.br
authors.forename: Monica Paschoal
authors.initials: MP
authors.lastname: Nogueira
authors.forename: Julio Cesar Rodrigues
authors.initials: JC
authors.lastname: Pereira
authors.forename: Paulo Schiavom
authors.initials: PS
authors.lastname: Duarte
authors.forename: Alexandre
authors.initials: A
authors.lastname: Lourenço
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Tedesco
authors.forename: Laura Alves
authors.initials: LA
authors.lastname: Ferreira
authors.forename: Edilson
authors.initials: E
authors.lastname: Forlin
authors.forename: Reinaldo
authors.initials: R
authors.lastname: Volpi
authors.forename: Francisco
authors.initials: F
authors.lastname: Violante
authors.forename: Gilberto
authors.initials: G
authors.lastname: Brandão
authors.forename: Eduardo
authors.initials: E
authors.lastname: Novaes
authors.forename: José Luis Amin
authors.initials: JL
authors.lastname: Zabeu
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Kim
authors.forename: Carlos
authors.initials: C
authors.lastname: Aguiar
authors.forename: Maria Henriqueta Renno
authors.initials: MH
authors.lastname: Merlotti
mesh_terms: D001291:Attitude of Health Personnel; D001938:Brazil / Q000453:epidemiology; D002370:Casts, Surgical / Q000706:statistics & numerical data; D002648:Child; D003025:Clubfoot / Q000208:ethnology / Q000628:therapy*; D004502:Education, Medical, Continuing / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D033181:Information Dissemination; D026201:Musculoskeletal Manipulations / Q000706:statistics & numerical data; D009313:National Health Programs / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D009985:Orthopedics / Q000193:education / Q000458:organization & administration* / Q000706:statistics & numerical data; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data; D010865:Pilot Projects; D015397:Program Evaluation; D011795:Surveys and Questionnaires
references.citation: Pediatrics. 2004 Feb;113(2):376-80
references.pmid: 14754952
references.citation: J Bone Joint Surg Am. 2004 Jan;86(1):22-7
references.pmid: 14711941
references.citation: Isr Med Assoc J. 2005 May;7(5):307-10
references.pmid: 15909463
references.citation: J Bone Joint Surg Am. 1992 Mar;74(3):448-54
references.pmid: 1548277
references.citation: Clin Orthop Relat Res. 2009 May;467(5):1298-305
references.pmid: 19190971
references.citation: Disabil Rehabil. 2007 Jun 15-30;29(11-12):857-62
references.pmid: 17577720
references.citation: Z Orthop Ihre Grenzgeb. 2006 Jan-Feb;144(1):80-6
references.pmid: 16498565
references.citation: J Bone Joint Surg Am. 1980 Jan;62(1):23-31
references.pmid: 7351412
references.citation: J Bone Joint Surg Br. 2007 Mar;89(3):378-81
references.pmid: 17356154
references.citation: J Pediatr Orthop. 2002 Jul-Aug;22(4):517-21
references.pmid: 12131451
references.citation: Bull World Health Organ. 2002;80(10):829-35
references.pmid: 12471405
references.citation: J Bone Joint Surg Am. 2003 Sep;85(9):1847; discussion 1847
references.pmid: 12954851
references.citation: J Pediatr Orthop. 1990 Jan-Feb;10(1):109-19
references.pmid: 2137134
references.citation: Clin Orthop Relat Res. 2009 May;467(5):1164-70
references.pmid: 18987922
references.citation: Rev Chir Orthop Reparatrice Appar Mot. 2002 Nov;88(7):710-7
references.pmid: 12457118
references.citation: Clin Orthop Relat Res. 2006 Mar;444:224-8
references.pmid: 16456307
references.citation: J Bone Joint Surg Am. 2006 May;88(5):986-96
references.pmid: 16651573
references.citation: Clin Orthop Relat Res. 2009 May;467(5):1154-63
references.pmid: 19308648
references.citation: Acta Orthop Traumatol Turc. 2002;36(4):281-7
references.pmid: 12510061
references.citation: J Bone Joint Surg Am. 1995 Oct;77(10):1477-89
references.pmid: 7593056
references.citation: Int Orthop. 2008 Feb;32(1):75-9
references.pmid: 17115153
references.citation: J Pediatr Orthop. 2005 Sep-Oct;25(5):627-9
references.pmid: 16199944
references.citation: J Bone Joint Surg Br. 2006 Aug;88(8):1085-9
references.pmid: 16877611
references.citation: J Pediatr Orthop B. 2007 Mar;16(2):98-105
references.pmid: 17273035
references.citation: J Foot Ankle Surg. 2003 Sep-Oct;42(5):259-67
references.pmid: 14566717