Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Sep 2;11(9):e049212.
doi: 10.1136/bmjopen-2021-049212.

Attaining a British consensus statement on managing idiopathic congenital talipes equinovarus (CTEV) through a Delphi process: a study protocol

Yael Gelfer  1 , Jose Blanco  2 , Amanda Trees  3 , Naomi Davis  4 , Rachel Buckingham  5 , Anna C Peek  6 , Elizabeth Wright  7 , Rohan Rajan  8 , William Guy Atherton  9 , Denise Watson  10 , Vicky Easton  11 , Neeraj Garg  12 , Jason Mavrotas  13 , Sally Tennant  14 , Tim Theologis  15
Affiliations

Attaining a British consensus statement on managing idiopathic congenital talipes equinovarus (CTEV) through a Delphi process: a study protocol

Yael Gelfer et al. BMJ Open. .

Abstract

Introduction: Idiopathic congenital talipes equinovarus (CTEV) is the most common congenital limb deformity. Non-operative intervention using the Ponseti method has shown to be superior to soft tissue release and has become the gold standard for first-line treatment. However, numerous deviations from the Ponseti protocol are still reported following incomplete correction or deformity relapse. Significant variation in treatment protocols and management is evident in the literature. Reducing geographical treatment variation has been identified as one of The James Lind Alliance priorities in children's orthopaedics. For this reason, the British Society of Children's Orthopaedic Surgery (BSCOS) commissioned a consensus document to form a benchmark for practitioners and ensure consistent high quality care for children with CTEV.

Methods and analysis: The consensus will follow an established Delphi approach aiming at gaining an agreement on the items to be included in the consensus statement for the management of primary idiopathic CTEV up to walking age. The process will include the following steps: (1) establishing a steering group, (2) steering group meetings, (3) a two-round Delphi survey aimed at BSCOS members, (4) final consensus meeting and (5) dissemination of the consensus statement. Degree of agreement for each item will be predetermined. Descriptive statistics will be used for analysis of the Delphi survey results.

Ethics and dissemination: No patient involvement is required for this project. Informed consent will be assumed from participants taking part in the Delphi survey. Study findings will be published in an open access journal and presented at relevant national and international conferences. Charities and associations will be engaged to promote awareness of the consensus statement.

Keywords: paediatric orthopaedics; protocols & guidelines; statistics & research methods.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flowchart of the study stages and timeline. BSCOS, British Society of Children’s Orthopaedic Surgery; CTEV, congenital talipes equinovarus.
See this image and copyright information in PMC

References

    1. Gibbons PJ, Gray K. Update on clubfoot. J Paediatr Child Health 2013;49:E434–7. 10.1111/jpc.12167 - DOI - PubMed
    1. Dobbs MB, Gurnett CA. Update on clubfoot: etiology and treatment. Clin Orthop Relat Res 2009;467:1146–53. 10.1007/s11999-009-0734-9 - DOI - PMC - PubMed
    1. Smythe T, Kuper H, Macleod D, et al. . Birth prevalence of congenital talipes equinovarus in low- and middle-income countries: a systematic review and meta-analysis. Trop Med Int Health 2017;22:269–85. 10.1111/tmi.12833 - DOI - PubMed
    1. Chen C, Kaushal N, Scher DM, et al. . Clubfoot etiology: a meta-analysis and systematic review of observational and randomized trials. J Pediatr Orthop 2018;38:e462–9. 10.1097/BPO.0000000000001191 - DOI - PubMed
    1. Morcuende JA, Dolan LA, Dietz FR, et al. . Radical reduction in the rate of extensive corrective surgery for clubfoot using the Ponseti method. Pediatrics 2004;113:376–80. 10.1542/peds.113.2.376 - DOI - PubMed

LinkOut - more resources