Quality of life of clubfoot patients during the brace period of the Ponseti method

Using a Popular Video Platform to Assess Patient Perceptions of Clubfoot Deformity

BACKGROUND

In today's world, individuals receive much of their medical information from the Internet, including social media platforms such as the increasingly popular TikTok, a video-sharing site. This study's purpose was to better understand the content popular online regarding clubfoot deformity.

METHODS

The 50 most viewed, English language videos on TikTok with the tags #clubfootjourney, #talipes, #clubfootcast, #clubfoottreatment, and #clubfoot were identified and independently evaluated by 2 separate reviewers for creator demographics, video type, and prominent themes. Videos were also assessed for medical accuracy and given a score for understandability and actionability based on the Patient Education Materials Assessment Tool (PEMAT).

RESULTS

In total, the videos had 87.7 million views, 3.8 million "likes", and 42.1 thousand comments. Health care professionals created 10% of the videos, and only 1 video was made by an orthopaedic surgeon. Of all the videos, including those created by non-health-care professionals, 82% included medically substantiated and accurate claims. A majority of the videos were primarily educational (70%), with the remainder primarily motivational (30%). Tone varied between positive (74%), and neutral (26%) with no negative tone although most watched videos accounting for 30 million views were primarily motivational. Prominent themes included casting journey (32%), medical education/demonstration (22%), and adults with clubfoot deformity (12%). Ideas such as fear, pain, and discomfort (55%), the importance of family support (25%), and hygiene (20%) were also represented. None of the videos exhibited themes of race in medicine or socioeconomic barriers. All videos were also found to have an average understandability of 74.3% and an average actionability of 36.3%, according to the PEMAT.

CONCLUSIONS

The substantial number of views and "likes" accumulated by these videos highlights the breadth of content and utilization of social media by the public. This study reveals an opportunity for health care professionals to reach patients with accurate information, identify areas of fear/distrust, and address negative or incorrect perceptions that pervades a variety of interventions with regards to clubfoot deformity management and treatment.

Evaluating the quality of life in mothers caring for children with congenital clubfoot: prospective sequential evaluation along the course of Ponseti management

The post birth revelation of child with physical anomaly taxes maternal hopes of a healthy child. However, unlike many other congenital anomalies, the Ponseti method has enabled an early and effective treatment of the clubfoot deformity. Our study aimed to assess the quality of life (QoL) of mothers with child born with idiopathic clubfoot through various stages of its management compared to a healthy infant. The study was conducted on mothers of children born with untreated congenital idiopathic clubfoot presenting within first 3 months after birth and undergoing Ponseti treatment. The WHO Quality of Life Instrument (QoL), Short Form (WHOQOL-BREF) questionnaire was used to capture maternal responses at enrolment of the child at the clubfoot clinic, at percutaneous Achilles tenotomy, 3 weeks post tenotomy, and 1 month after prescription of foot abduction brace. Intertreatment comparison of QoL responses was performed. Baseline values for QoL domains were obtained for mothers born with healthy infants (controls). Responses from 29 affected mothers and 30 controls were available. The QoL responses from affected mothers were significantly lower than those born with healthy children. The domains most affected were psychological health and environment ( P  < 0.001). Subsequent responses through various stages of Ponseti management remained comparable. Although the affected mothers' QoL was lower than mothers of healthy child, they were pacified by the available treatment and the counseling for clubfoot. Physical health and social relationship domains were no longer areas of concern for them. Further, there was no change of QoL across sequential Ponseti management.

The Importance of Having a Single, Dedicated Medical Team to Treat Congenital Talipes Equinovarus Using the Ponseti Method: A Retrospective Analysis of Treatment Outcomes After 3 Years of Follow-up

BACKGROUND

Congenital talipes equinovarus (CTEV) is a relatively common pediatric orthopaedic disorder and a frequent cause of disability in adult populations. The Ponseti method has emerged as the generally preferred for treating children with CTEV. Strict adherence to this technique's basic principles is critical to achieving favorable outcomes. In 2013, our institution decided that every case of pediatric CTEV would be treated by a single dedicated medical team. The present study aimed to compare the treatment outcomes of children with CTEV treated using the Ponseti method in period I (multiple surgeons) versus those in period II (single dedicated team).

PATIENTS AND METHODS

We included respectively the children with CTEV treated using the Ponseti method in Geneva University Hospitals' pediatric units from 2007 to 2018. Data on patient demographics, clinical characteristics, and the treatment outcomes were collected. The primary outcome was the number of relapsed feet (treatment failure) after 3 years of follow-up. The 2 periods' outcomes were compared using χ 2 and independent Student t -tests. Run charts were used to report yearly rates of complications, minor and major recurrences, treatment failure, brace noncompliance, and feet that underwent tenotomy.

RESULTS

A total of 48 feet (32 patients) and 42 feet (29 patients) in periods I and II were included. The periods showed similar rates for participants' characteristics. The run charts illustrated the overall improvements in treatment outcomes in period II. A total of 8 relapsed feet (5 patients) were reported, all during period I.

CONCLUSIONS

Since all the pediatric CTEV patients at our institution began to be treated by a single dedicated medical team, we have observed a decrease in all recurrences and complications and an absence of treatment failure. These results highlight the importance of the continuity of care and strict adherence to the Ponseti method.

LEVEL OF EVIDENCE

Level-III Retrospective comparative study.