Abstract
The aim of this study was to assess a 'hub and spoke' model for a treatment of clubfoot that involves the casting of feet by trained physiotherapists based at local hospitals close to the patients' homes. It has been demonstrated that non-medical personnel can be trained effectively in the Ponseti technique in developing nations where resources and orthopaedic surgeons are scarce. 1–5 In the UK the British Orthopaedic Association published the 'blue book' on children's orthopaedics in 2006, which advises a hub and spoke model to address the issue of a shortage of paediatric orthopaedic surgeons in peripheral district general hospitals (DGHs). 6 The extent of subspecialisation among orthopaedic surgeons and the lack of paediatric anaesthetists have reduced peripheral paediatric orthopaedic surgical treatment. We believe there is no study in the literature to date assessing the advantages of such a service using existing physiotherapy facilities at multiple centres.
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