title: The hybrid method for the treatment of congenital talipes equinovarus: preliminary results on 92 consecutive feet.
abstract: Over the past 4 years, our pediatric orthopedic unit has developed a new hybrid protocol combining the advantages of Ponseti's method and the French functional physiotherapy method. Sixty-one patients (92 feet) completed treatment. Clubfoot was unilateral in 30 (49.2%) patients and bilateral in 31 (50.8%) patients. The mean Dimeglio score at the start of treatment was 13.5/20 (range: 6/20-19/20). All patients had clinical and radiographic follow-up for at least 2 years (range: 2-4 years). If orthopedic treatment was ineffective and feet showed no improvement, further surgery was performed. Posterior release was performed in eight (8.7%) feet. Clinical evaluation at the last follow-up found a mean dorsal flexion of 20°±5° (range: 5°-35°). The hybrid method is a combination approach applying the strengths of Ponseti's method, that is, serial casting, and the French physiotherapy method, that is, manipulations and radiographs, to achieve long-term correction with a foot that is fully functional and pain free.
authors.affiliation: aDepartment of Pediatric Surgery, University Hospital Estaing, Clermont Ferrand bUniversity of Montpellier, Faculty of Medicine, Montpellier, France.
authors.forename: Federico
authors.initials: F
authors.lastname: Canavese
authors.forename: Mounira
authors.initials: M
authors.lastname: Mansour
authors.forename: Guillemette
authors.initials: G
authors.lastname: Moreau-Pernet
authors.forename: Yannael
authors.initials: Y
authors.lastname: Gorce
authors.forename: Alain
authors.initials: A
authors.lastname: Dimeglio
mesh_terms: D002370:Casts, Surgical; D002675:Child, Preschool; D003025:Clubfoot / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005528:Foot / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008349:Manipulation, Orthopedic / Q000379:methods*; D019637:Orthopedic Procedures / Q000379:methods; D009985:Orthopedics / Q000379:methods; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular; D000070558:Talipes / Q000628:therapy*; D016896:Treatment Outcome