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Abstract：
Congenital talipes equino-varus (CTEV), also known as clubfoot, is one of the most common congenital musculoskeletal malformations. Despite this, considerable variation exists in the measurement of deformity correction and outcome evaluation. This study aims to determine the criteria for successful clubfoot correction using the Ponseti technique in low resource settings through Africa.
Using the Delphi method, 18 experienced clubfoot practitioners and trainers from ten countries in Africa ranked the importance of 22 criteria to define an \'acceptable or good clubfoot correction\' at the end of bracing with the Ponseti technique. A 10cm visual analogue scale was used. They repeated the rating with the results of the mean scores and standard deviation of the first test provided. The consistency among trainers was determined with the intra-class correlation coefficient (ICC). From the original 22 criteria, ten criteria with a mean score >7 and SD <2 were identified and were rated through a second Delphi round by 17 different clubfoot treatment trainers from 11 countries in Africa. The final definition consisted of all statements that achieved strong agreement, a mean score of >9 and SD<1.5.
The consensus definition of a successfully treated clubfoot includes: (1) a plantigrade foot, (2) the ability to wear a normal shoe, (3) no pain, and (4) the parent is satisfied. Participants demonstrated good consistency in rating these final criteria (ICC 0.88; 0.74,0.97).
The consistency of Ponseti technique trainers from Africa in rating criteria for a successful outcome of clubfoot management was good. The consensus definition includes basic physical assessment, footwear use, pain and parent satisfaction.
Using the Delphi method, 18 experienced clubfoot practitioners and trainers from ten countries in Africa ranked the importance of 22 criteria to define an \'acceptable or good clubfoot correction\' at the end of bracing with the Ponseti technique. A 10cm visual analogue scale was used. They repeated the rating with the results of the mean scores and standard deviation of the first test provided. The consistency among trainers was determined with the intra-class correlation coefficient (ICC). From the original 22 criteria, ten criteria with a mean score >7 and SD <2 were identified and were rated through a second Delphi round by 17 different clubfoot treatment trainers from 11 countries in Africa. The final definition consisted of all statements that achieved strong agreement, a mean score of >9 and SD<1.5.
The consensus definition of a successfully treated clubfoot includes: (1) a plantigrade foot, (2) the ability to wear a normal shoe, (3) no pain, and (4) the parent is satisfied. Participants demonstrated good consistency in rating these final criteria (ICC 0.88; 0.74,0.97).
The consistency of Ponseti technique trainers from Africa in rating criteria for a successful outcome of clubfoot management was good. The consensus definition includes basic physical assessment, footwear use, pain and parent satisfaction.
摘要：
先天性内翻(CTEV)也被称为马蹄内翻足，是最常见的先天性肌肉骨骼畸形之一。尽管如此,畸形矫正和结果评估的测量存在相当大的差异。这项研究旨在确定在非洲低资源环境中使用Ponseti技术成功矫正马蹄内翻足的标准。
使用Delphi方法，来自非洲10个国家/地区的18位经验丰富的马蹄足从业者和培训师对22项标准的重要性进行了排名，以在使用Ponseti技术进行支撑时定义“可接受或良好的马蹄足矫正”。使用10cm视觉模拟量表。他们用提供的第一次测试的平均分数和标准偏差的结果重复评级。用类内相关系数（ICC）确定培训者之间的一致性。从最初的22个标准来看，来自非洲11个国家的17名不同马蹄内翻足治疗培训师确定了10项平均分>7且SD<2的标准,并通过第二轮Delphi对其进行了评分.最终的定义包括所有达成强烈一致的声明，平均评分>9，SD<1.5。
成功治疗的马蹄内翻足的共识定义包括：（1）足足，（2）穿鞋能力正常，（3）没有疼痛，（4）父母满意。参与者在对这些最终标准进行评级方面表现出良好的一致性(ICC0.88;0.74,0.97)。
来自非洲的Ponseti技术培训师在马蹄足管理成功结果的评级标准上的一致性很好。共识定义包括基本的身体评估，鞋类使用,痛苦和父母的满意度。
使用Delphi方法，来自非洲10个国家/地区的18位经验丰富的马蹄足从业者和培训师对22项标准的重要性进行了排名，以在使用Ponseti技术进行支撑时定义“可接受或良好的马蹄足矫正”。使用10cm视觉模拟量表。他们用提供的第一次测试的平均分数和标准偏差的结果重复评级。用类内相关系数（ICC）确定培训者之间的一致性。从最初的22个标准来看，来自非洲11个国家的17名不同马蹄内翻足治疗培训师确定了10项平均分>7且SD<2的标准,并通过第二轮Delphi对其进行了评分.最终的定义包括所有达成强烈一致的声明，平均评分>9，SD<1.5。
成功治疗的马蹄内翻足的共识定义包括：（1）足足，（2）穿鞋能力正常，（3）没有疼痛，（4）父母满意。参与者在对这些最终标准进行评级方面表现出良好的一致性(ICC0.88;0.74,0.97)。
来自非洲的Ponseti技术培训师在马蹄足管理成功结果的评级标准上的一致性很好。共识定义包括基本的身体评估，鞋类使用,痛苦和父母的满意度。
