■缺乏高质量的研究来调查Ponseti治疗的特发性马蹄内翻足的结果以及与复发的相关性。本研究使用标准化核心结果集(COS)评估临床和生活质量(QoL)结果,比较有和没有复发的儿童。
■共有11个国际中心参与了这项机构审查委员会批准的观察性研究。数据包括人口统计,关于演示的信息,治疗,我们收集了2022年6月1日至2023年6月30日期间至少接受5年随访的连续临床患者的后续复发和治疗详情.使用包含31个参数的马蹄足COS。回归模型评估了基线变量与结果(临床/QoL)之间的关系。
■总的来说,包括293名患者(432英尺),中位年龄为89个月(四分位距72至113)。复发率为37%,14%反复复发。治疗被认为是Ponseti旅程的标准部分(重铸,重复肌腱切开术,胫骨前肌腱转移)在35%的病例中进行,在5%和2%的病例中有软组织松解术和截骨术,分别。复发的预测因素包括随访时间,较高的Pirani初始分数,和不良的Evertor肌肉活动。复发与较差的结果相关。
■这是第一个在马蹄足治疗后使用标准化COS的多中心研究。它在临床结果和QoL方面区分有复发和无复发的患者,复发组的结局较差。该工具可以比较治疗方法和结果,促进信息共享,并设定家庭期望。复发的预测因素鼓励我们创建适当的治疗途径以减少复发并改善预后。
UNASSIGNED: There is a lack of high-quality research investigating outcomes of Ponseti-treated idiopathic clubfeet and correlation with relapse. This
study assessed clinical and quality of life (QoL) outcomes using a standardized core outcome set (COS), comparing children with and without relapse.
UNASSIGNED: A total of 11 international centres participated in this institutional review board-approved observational
study. Data including demographics, information regarding presentation, treatment, and details of subsequent relapse and management were collected between 1 June 2022 and 30 June 2023 from consecutive clinic patients who had a minimum five-year follow-up. The clubfoot COS incorporating 31 parameters was used. A regression model assessed relationships between baseline variables and outcomes (clinical/QoL).
UNASSIGNED: Overall, 293 patients (432 feet) with a median age of 89 months (interquartile range 72 to 113) were included. The relapse rate was 37%, with repeated relapse in 14%. Treatment considered a standard part of the Ponseti journey (recasting, repeat
tenotomy, and tibialis anterior tendon transfer) was performed in 35% of cases, with soft-tissue release and osteotomies in 5% and 2% of cases, respectively. Predictors of relapse included duration of follow-up, higher initial Pirani score, and poor Evertor muscle activity. Relapse was associated with poorer outcomes.
UNASSIGNED: This is the first multicentre
study using a standardized COS following clubfoot treatment. It distinguishes patients with and without relapse in terms of clinical outcomes and QoL, with poorer outcomes in the relapse group. This tool allows comparison of treatment methods and outcomes, facilitates information sharing, and sets family expectations. Predictors of relapse encourage us to create appropriate treatment pathways to reduce relapse and improve outcome.