COMPARISON BETWEEN TWO TYPES OF ABDUCTION ORTHOTICS IN TREATING CONGENITAL CLUBFOOT

ABSTRACT Objective: The objective of this study was to analyze and compare the effectiveness of two types of abduction orthotics used for the feet, the Denis-Browne type (traditional) and the Dobbs type (dynamic), with regard to maintenance of deformity correction and prevention of recurrence . Method: In this comparative retrospective case study, information was collected from the medical records of children with idiopathic congenital clubfoot (CCF). We evaluated a total of 43 feet in 28 patients, which were divided into two groups. Group 1 was comprised of 16 patients with a total of 24 CCFs treated with the traditional orthotic device. Group 2 consisted of 12 patients with a total of 19 CCFs treated with the dynamic orthotic device. The statistical analysis used the ANOVA test to compare the categorical variables between the groups. A significance level of 5% was adopted (p-value≤0.05) . Results: In Group 1, recurrence was observed in 2 feet (8.33%), and in 1 foot in Group 2 (5.26%). No significant difference in effectiveness was seen between the two types of orthotic devices . Conclusion: Both abduction devices were seen to be effective in maintaining correction of congenital clubfoot deformities. There was no statistical significance between type of orthotic device and recurrence. Level of Evidence III, Retrospective Comparative Study.

摘要
研究目的：本研究旨在分析并比较两种足部外展矫形器（abduction orthotics）——丹尼斯-布朗型（Denis-Browne type，传统型）与多布斯型（Dobbs type，动态型），在维持畸形矫正效果及预防复发方面的有效性。
研究方法：本研究为回顾性对照病例研究，数据收集自特发性先天性马蹄内翻足（idiopathic congenital clubfoot, CCF）患儿的医疗记录。本研究共纳入28例患儿的43只患足，分为两组。第1组纳入16例患儿，共计24只患足，采用传统外展矫形器治疗；第2组纳入12例患儿，共计19只患足，采用动态外展矫形器治疗。统计学分析采用方差分析（ANOVA test）比较组间分类变量，设定显著性水平为5%（P值≤0.05）。
研究结果：第1组中2只患足出现复发（占比8.33%），第2组中1只患足出现复发（占比5.26%）。两种矫形器的治疗有效性未发现显著差异。
研究结论：两种外展矫形器均能有效维持先天性马蹄内翻足畸形的矫正效果，矫形器类型与复发率之间无统计学显著性差异。本研究证据等级为Ⅲ级，属于回顾性对照研究。