An Analysis of the Mechanical Properties of the Ponseti Method in Clubfoot Treatment
Congenital clubfoot is a complex pediatric foot deformity, occurring in approximately 1 in 1000 live births and resulting in significant disability, deformity, and pain if left untreated. The Ponseti method of manipulation is widely recognized as the gold standard treatment for congenital clubfoot;...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Applied Bionics and Biomechanics |
| Online Access: | http://dx.doi.org/10.1155/2019/4308462 |
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| author | Murtaza Kadhum Mu-Huan Lee Jan Czernuszka Chris Lavy |
| author_facet | Murtaza Kadhum Mu-Huan Lee Jan Czernuszka Chris Lavy |
| author_sort | Murtaza Kadhum |
| collection | DOAJ |
| description | Congenital clubfoot is a complex pediatric foot deformity, occurring in approximately 1 in 1000 live births and resulting in significant disability, deformity, and pain if left untreated. The Ponseti method of manipulation is widely recognized as the gold standard treatment for congenital clubfoot; however, its mechanical aspects have not yet been fully explored. During the multiple manipulation-casting cycles, the tendons and ligaments on the medial and posterior aspect of the foot and ankle, which are identified as the rate-limiting tissues, usually undergo weekly sequential stretches, with a plaster of Paris cast applied after the stretch to maintain the length gained. This triggers extracellular matrix remodeling and tissue growth, but due to the viscoelastic properties of tendons and ligaments, the initial strain size, rate, and loading history will affect the relaxation behavior and mechanical strength of the tissue. To increase the efficiency of the Ponseti treatment, we discuss the theoretical possibilities of decreasing the size of the strain step and interval of casting and/or increasing the overall number of casts. This modification may provide more tensile stimuli, allow more time for remodeling, and preserve the mechanical integrity of the soft tissues. |
| format | Article |
| id | doaj-art-d36d8b97d34d448782d529d20ba580b0 |
| institution | Kabale University |
| issn | 1176-2322 1754-2103 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Applied Bionics and Biomechanics |
| spelling | doaj-art-d36d8b97d34d448782d529d20ba580b02025-02-03T01:28:15ZengWileyApplied Bionics and Biomechanics1176-23221754-21032019-01-01201910.1155/2019/43084624308462An Analysis of the Mechanical Properties of the Ponseti Method in Clubfoot TreatmentMurtaza Kadhum0Mu-Huan Lee1Jan Czernuszka2Chris Lavy3Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, Oxford University, UKDepartment of Materials, Oxford University, UKDepartment of Materials, Oxford University, UKNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, Oxford University, UKCongenital clubfoot is a complex pediatric foot deformity, occurring in approximately 1 in 1000 live births and resulting in significant disability, deformity, and pain if left untreated. The Ponseti method of manipulation is widely recognized as the gold standard treatment for congenital clubfoot; however, its mechanical aspects have not yet been fully explored. During the multiple manipulation-casting cycles, the tendons and ligaments on the medial and posterior aspect of the foot and ankle, which are identified as the rate-limiting tissues, usually undergo weekly sequential stretches, with a plaster of Paris cast applied after the stretch to maintain the length gained. This triggers extracellular matrix remodeling and tissue growth, but due to the viscoelastic properties of tendons and ligaments, the initial strain size, rate, and loading history will affect the relaxation behavior and mechanical strength of the tissue. To increase the efficiency of the Ponseti treatment, we discuss the theoretical possibilities of decreasing the size of the strain step and interval of casting and/or increasing the overall number of casts. This modification may provide more tensile stimuli, allow more time for remodeling, and preserve the mechanical integrity of the soft tissues.http://dx.doi.org/10.1155/2019/4308462 |
| spellingShingle | Murtaza Kadhum Mu-Huan Lee Jan Czernuszka Chris Lavy An Analysis of the Mechanical Properties of the Ponseti Method in Clubfoot Treatment Applied Bionics and Biomechanics |
| title | An Analysis of the Mechanical Properties of the Ponseti Method in Clubfoot Treatment |
| title_full | An Analysis of the Mechanical Properties of the Ponseti Method in Clubfoot Treatment |
| title_fullStr | An Analysis of the Mechanical Properties of the Ponseti Method in Clubfoot Treatment |
| title_full_unstemmed | An Analysis of the Mechanical Properties of the Ponseti Method in Clubfoot Treatment |
| title_short | An Analysis of the Mechanical Properties of the Ponseti Method in Clubfoot Treatment |
| title_sort | analysis of the mechanical properties of the ponseti method in clubfoot treatment |
| url | http://dx.doi.org/10.1155/2019/4308462 |
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