FORGET ABOUT THE GOLD STANDARD WHAT ABOUT THE GOLDEN THREAD!

The condition CTEV (Congenital Talipes Equinovarus) or commonly known as Clubfoot is a complex condition. The Golden Standard of treatment for this condition is the Ponseti method of treatment. It is a non-surgical method that is commonly used by most facilities who treats orthopedic conditions, such as Shriners Hospitals and Childrens' Hospitals nationwide.

A lot of publications have hailed this treatment method as the Golden Standard of clubfoot treatments. Although parents and patients both are thankful that something non-surgical exists in the first place, treatment focus and planning for the future largely got stuck on this initial method that can only be applied between 0-5 years old. Older age applications have been tested but research states that to achieve the same level of success at an older age is difficult to achieve.

Parents and even some medical practitioners are concerned about the lack of research into the 'origin' of this condition and obvious things that has never received any attention in the past, at least in terms of research publications. Biopsies of tissues in adult patients, studying of collagen tissue types have been lacking in this condition.

Clubfoot runs like a Golden Thread through a number of seemingly unrelated conditions, as reported by parents and patients on the Clubfoot Research Forum and Foundation the past 7 years. Exampes are Marfan Syndrome, Arthrogryposis, Spina Bifida, Larsen's Syndrome, Klinefelter Syndrome and the list gets much longer than that.

Why does it show up in so many seemingly different conditions? This question has been under discussion in the CLUBFOOT RESEARCH FOUNDATION group since the beginning. Is the condition clubfoot really just a condition of the foot or does it involve much more than just a foot? What are the typical symptoms? What other body parts are affected? Is it different between patients?....and many more questions arising every day. Different genes play a role and identifying a specific causing gene has evaded researchers thus far. Much more funding and research needed to get closer to solve the puzzle.

These questions above are all unique opportunities for researchers. The Clubfoot Research Foundation would like to see that the GOLDEN THREAD gets more attention from researchers in the future. That other treatment options such as the French Functional Method gets the same consideration as there is evidence pointing towards better outcomes and muscle balance using other techniques.

A much broader approach is necessary to answer questions about this condition, not a simple single standard that do not address all patient variety! Hopefully this GOLDEN THREAD leads to more solutions for a variety of connective tissue disorders in the future.

Is Clubfoot research holding the key to solve some of these other puzzling conditions? Should each be viewed as a single condition or should a cluster of conditions be kept in mind? Cluster study of effects in a single patient is currently even further away than genetic studies. There is evidence in patient feedback regarding contrasting conditions that effects overall outcome. So much to study, so few researchers!