LEARNING CURVE IN PONSETI METHOD - EVOLUTION IN 5 YEAR-INTERVALS.

IF 0.5 4区医学 Q4 ORTHOPEDICS

Acta Ortopedica Brasileira Pub Date : 2024-03-22 eCollection Date: 2024-01-01 DOI:10.1590/1413-785220243201e273739

Tatiana de Moura Guerschman, Monica Paschoal Nogueira

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引用次数: 0

Abstract

Objective: Evaluate whether the experience of the surgeon could reduce Ponseti treatment time, and a number of cast changes, and the evolution of the Pirani Score.

Methods: 2 reference centers were evaluated. At Institution 1, 254 patients with idiopathic clubfoot (403 feet) were included, and at Institution 2, 32 patients (51 feet). At institution 1 (mentor), 3 intervals of 5 years each were analyzed. At the Institution 2 (trainee), 1 interval of 5 years was analyzed.

Results: Patients treated by the mentor had fewer casts compared with the trainee (p < 0.001). At Institution 1, the three mentor intervals showed differences in the number of casts (p < 0.05). A statistically significant difference was observed only in the first mentor interval (2000 to 2005, average of 3.47 casts) compared with the 2 other intervals (2005 to 2010; average of 2.6 casts and 2011 to 2015; average of 2.79 casts; p < 0.0001). Pirani score decreases the most until the third clinic visit.

Conclusion: The mentor's greater expertise was associated with fewer casts and shorter time to obtain correction in isolated clubfoot, especially right after the first 5 years of practice. Progression of the Pirani score in both institutions occurs between the first and the third casts. Level of Evidence III; Therapeutic Study, Retrospective Comparative Study.

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Ponseti 法的学习曲线 - 5 年间隔的演变。

目的评估外科医生的经验是否能缩短 Ponseti 治疗时间、减少石膏更换次数以及皮拉尼评分的变化。方法：对两个参考中心进行评估。第一参考中心有 254 名特发性马蹄内翻足患者（403 只脚），第二参考中心有 32 名患者（51 只脚）。在机构 1（导师），分析了 3 个间隔期，每个间隔期为 5 年。结果：结果：与受训者相比，接受指导者治疗的患者石膏数量更少（P < 0.001）。在第一医院，三个导师间隔期的石膏数量存在差异（P < 0.05）。只有第一个导师间隔期（2000 年至 2005 年，平均 3.47 个铸模）与其他两个间隔期（2005 年至 2010 年，平均 2.6 个铸模；2011 年至 2015 年，平均 2.79 个铸模；p < 0.0001）相比，出现了明显的统计学差异。皮拉尼评分在第三次门诊前下降幅度最大：结论：指导者的专业知识越丰富，孤立型马蹄内翻足的石膏用量就越少，矫正时间就越短，尤其是刚开始工作 5 年后。两家机构的皮拉尼评分都在第一次和第三次石膏固定之间有所提高。证据等级 III；治疗研究，回顾性比较研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Ortopedica Brasileira Orthopedics-

CiteScore

0.90

自引率

14.30%

发文量

审稿时长

25 weeks

期刊介绍： A Revista Acta Ortopédica Brasileira, órgão oficial do Departamento de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo (DOT/FMUSP), é publicada bimestralmente em seis edições ao ano (jan/fev, mar/abr, maio/jun, jul/ago, set/out e nov/dez) com versão em inglês disponível nos principais indexadores nacionais e internacionais e instituições de ensino do Brasil. Sendo hoje reconhecidamente uma importante contribuição para os especialistas da área com sua seriedade e árduo trabalho para as indexações já conquistadas.