Clubfoot management in the Middle East: a survey-based review.

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Abstract

Conflict of interest statement: Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/atm-21-33). The series “Clubfoot” was commissioned by the editorial office without any funding or sponsorship. The authors have no other conflicts of interest to declare. 15. J Am Acad Orthop Surg Glob Res Rev. 2022 Feb 15;6(2):e22.00008. doi: 10.5435/JAAOSGlobal-D-22-00008. Ponseti Clubfoot Casting: Factors That Affect Trainee Competency (Retrospective Observational Study). Noonan SO(1), Hetzel S, Noonan KJ, Herzenberg JE, Bae DS, Shore BJ. Author information: (1)From the University of Denver, Denver, Colorado (Noonan); the Department of Orthopaedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA (Dr. Bae and Dr. Shore); the Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD (Dr. Herzenberg); and the University of Wisconsin School of Medicine and Public Health, Madison WI (Dr. Hetzel, Dr. Noonan). INTRODUCTION: This study investigates how previous simulation training and clinical experience affects trainee performance when manipulating a foot, applying a Ponseti clubfoot cast, and performing an Achilles tenotomy on a clubfoot simulator. METHODS: Sixty-four Accreditation Council for Graduate Medical Education orthopaedic trainees participated in the 2017 to 2018 Top Gun (TG) skills competition at the International Pediatric Orthopaedic Symposium. Trainees were judged by expert pediatric orthopaedic surgeons on how they manipulated a clubfoot model, applied a cast, and performed a simulated tendoachilles tenotomy (TAT). An analysis was done to correlate the test variables with a contestant's TG Ponseti score. RESULTS: Twenty-one contestants with previous residency training using synthetic clubfoot models scored higher (P = 0.007) than those trainees without training. Trainees who had applied >10 clubfoot casts and who participated in >10 TATs in training also scored higher (P = 0.038 and P = 0.01, respectively). Thirteen contestants who had previously attended an International Pediatric Orthopaedic Symposium meeting and seven contestants who attended a American Academy of Orthopaedic Surgery clubfoot workshop scored higher (P = 0.012 and P = 0.017 respectively). DISCUSSION: Clinical and previous simulation experience related to the Ponseti method correlated with improved performance on our Ponseti simulation. Trainees who had previous experience with >10 clubfoot casts and >10 TATs scored higher during TG than less experienced trainees. Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons. DOI: 10.5435/JAAOSGlobal-D-22-00008 PMCID: PMC8849277