The effect of the internet in the treatment of congenital idiopathic clubfoot

Abstract

Parents have traditionally relied on health care professionals for advice and treatment for most orthopaedic conditions, including clubfoot. However, the unprecedented access to health care information offered by the Internet is changing how parents gather information and make treatment choices. This study was designed to evaluate the effect of the Internet in the treatment of clubfoot. We performed a retrospective review of the clinical census, statistics of the Virtual Hospital web pages on clubfoot, web sites, and web based support-groups related to clubfoot from 1995 to 2002. There were 157 patients that came to our clinic for treatment, a dramatic increase compared to previous years. There were a total of 790,084 hits to the Virtual Hospital web pages, with information requested from all states and 72 countries. Interestingly, the referrals also changed with patients coming from 30 states and 8 different countries, compared to previous years when the majority came from our own state. In addition, 75% of the patients were self-referred, many of them while on treatment at outside institutions. There were 160 web sites providing information on clubfoot and 5 large support groups. There were approximately 30,000 messages (average 1000 messages/month) posted into the support clubfoot websites. After visiting Internet support groups, 125 parents transferred or initiated the care of their children to a doctor practicing the Ponseti method. In conclusion, the Internet provides a mean for parents to obtain disease-specific information in a timely manner. Parents used the support-groups to find and proffer information, share experiences and opinions, and provide encouragement. This sharing of information is affecting how parents make their treatment choices and also has the potential to induce unexpected changes in clinical orthopaedic practice.

Figure 1

Number of hits at the Virtual Hospital clubfoot web page. Note the increase over the short period of time, to a total of 790,084.

Figure 2

Number of patients seen in clinic from 1995 to 2001. Note the dramatic increase since 1998 when the Virtual Hospital clubfoot web pages were posted.

Figure 3. Total number of members at Internet sites

Note the exponential increase in the number in the general web sites and in the Ponseti method.

Figure 4

Number of messages posted at the different web sites. Note the correlation between the number of messages in the general site and the Ponseti web site (four months weighted average).