Clubfoot Treatment: Dr. Ponseti Knew Value
摘要
Value = outcomes/cost (Porter, N Engl J Med 363:2477–2481, 2010). Value-based care can be effectively applied to the conservative treatment of clubfoot in infants under 1 year of age. In many cases, excellent outcomes are achieved at reduced costs, thereby improving value. The clinical clubfoot team should guide the process, including gentle manipulation to correct all components of the deformity, well-molded casting, Achilles tendon lengthening, and subsequent bracing. Treatment should begin shortly after the diagnosis has been made and as soon as the infant’s general condition permits. Parental education about brace application and duration is essential to minimize relapse. If a relapse does occur, restarting conservative management using the Ponseti method can be effective. Well-performed Ponseti casting can enhance value in the care of infants with clubfoot.