title: Does Clubfoot Treatment Need to Begin As Soon As Possible?
abstract: BACKGROUND
  Parents of an infant with an idiopathic clubfoot deformity are often urged by their primary care physician to seek treatment as soon as possible. This advice frequently appears in many general pediatric and pediatric orthopaedic textbooks and monographs on the subject. This recommendation has not changed since the wide acceptance of the minimally invasive Ponseti method to treat clubfoot. We determined the correlations among patient-related variables, early treatment variables, and the age at which the patient was first seen to begin treatment.
  
  
  METHODS
  Infants with moderate to very severe idiopathic clubfoot deformity were invited to participate. Age at which the patient presented to begin treatment was correlated against early treatment-related variables, including number of casts required, cast slippage, cast-related skin problems, brace-related skin problems, early noncompliance with brace wearing, and relapse before 1 year. Patient-related variables were also correlated against age at first visit.
  
  
  RESULTS
  Over 7 years, 176 infants met the inclusion criteria. There were no significant differences in the aspects of the early management as a function of age at first visit, with the exception of cast slippage (P=0.05).
  
  
  CONCLUSIONS
  The age at first visit influenced the incidence of cast slippage, but otherwise did not affect the early treatment of clubfoot.
  
  
  CONCLUSIONS
  The treatment of idiopathic clubfoot deformity should not be considered an orthopaedic emergency, and parents whose infants are born with this deformity should be counseled accordingly.
authors.affiliation: Orthopaedic Institute for Children, David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors.forename: Lewis E
authors.initials: LE
authors.lastname: Zionts
authors.forename: Sophia N
authors.initials: SN
authors.lastname: Sangiorgio
authors.forename: Shannon D
authors.initials: SD
authors.lastname: Cooper
authors.forename: Edward
authors.initials: E
authors.lastname: Ebramzadeh
mesh_terms: D000367:Age Factors; D053587:Arthrometry, Articular / Q000379:methods; D002140:California; D002370:Casts, Surgical / Q000009:adverse effects / Q000706:statistics & numerical data; D002648:Child; D003025:Clubfoot / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D007223:Infant; D000069451:Long Term Adverse Effects / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008349:Manipulation, Orthopedic / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D010043:Outcome and Process Assessment, Health Care; D055502:Secondary Prevention; D012720:Severity of Illness Index; D061665:Time-to-Treatment / Q000592:standards / Q000706:statistics & numerical data