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Contents loading... Editors loading... Categories loading... When refering to evidence in academic writing, you should always try to reference the primary (original) source. That is usually the journal article where the information was first stated. In most cases Physiopedia articles are a secondary source and so should not be used as references. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement. Introduction[edit | edit source]The Ponseti method has become the gold standard in isolated clubfoot care and is associated with fewer surgical revisions, decreased cost, and most importantly, better long-term functional outcomes compared with primary soft tissue release surgery[1]. However for good outcomes it requires rigid adherence to the intervention which consists of specific serial manipulations, casting and tenotomy of the Achilles tendon, followed by abduction bracing of the affected foot or feet until the child is 2 to 4 years old. Health care professionals must not deviate from the protocol and [1] and parents and caregivers are required to give the long-term commitment in order to achieve a successful outcome. Non-adherence is one of the key reasons for failure of clubfoot treatment. This non-adherence can relate to health care practitioners not strictly following the Ponseti regime of interventions[1], but more commonly refers to poor adherence by parents and caregivers which is often as a result of the many barriers faced by parents and caregivers. Adherence and health care professionals[edit | edit source]Miller et al[1] reported that rigid commitment to the Ponseti method in the conservative treatment of patients with isolated clubfoot was associated with a lower risk of subsequent unplanned surgical intervention. They reported that clinics that have implemented variations of the Ponseti technique have had less than optimal results, including the likelihood of converting to a surgical approach, ranging from 10% to 40%[1]. To address deviations from the Ponseti method the following things may may considered:
Adherence and parents / caregivers[edit | edit source]Parents and caregivers have a major role treating the child with clubfoot[2][3]. Their responsibility includes regular attendance at clinic and long term brace application. According to Göksan et al[2], patient and family adherence to brace use is a common problem, as non-adherence is directly related to relapse. However there are many factors that may contribute to parents and caregivers not adhering to the Ponseti treatment protocol. These may include:
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What is most important when teaching a parent about preventing osteomyelitis?One way to prevent osteomyelitis is to keep skin clean. All cuts and wounds — especially deep wounds — should be cleaned well. Wash a wound with soap and water, holding it under running water for at least 5 minutes to flush it out.
Which of the following assessment techniques should be performed that will best detect the presence of an increase in intracranial pressure?Imaging- a computed tomography (CT) of the head or magnetic resonance imaging (MRI) can reveal signs of raised ICP such as enlarged ventricles, herniation, or mass effect from causes such as tumors, abscesses, and hematomas, among others. In this procedure, a needle is introduced in the subarachnoid space.
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