{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T14:41:06Z","timestamp":1781275266664,"version":"3.54.1"},"reference-count":25,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>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\u2019s orthopaedics. For this reason, the British Society of Children\u2019s Orthopaedic Surgery (BSCOS) commissioned a consensus document to form a benchmark for practitioners and ensure consistent high quality care for children with CTEV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and analysis<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Ethics and dissemination<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2021-049212","type":"journal-article","created":{"date-parts":[[2022,2,14]],"date-time":"2022-02-14T08:12:25Z","timestamp":1644826345000},"page":"e049212","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Attaining a British consensus statement on managing idiopathic congenital talipes equinovarus (CTEV) through a Delphi process: a study protocol"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8212-9999","authenticated-orcid":false,"given":"Yael","family":"Gelfer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Blanco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Trees","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Davis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Buckingham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna C","family":"Peek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Wright","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan","family":"Rajan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William Guy","family":"Atherton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Watson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicky","family":"Easton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neeraj","family":"Garg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Mavrotas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"Tennant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4758-9081","authenticated-orcid":false,"given":"Tim","family":"Theologis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,9,2]]},"reference":[{"key":"2022021323311750000_11.9.e049212.1","doi-asserted-by":"crossref","first-page":"E434","DOI":"10.1111\/jpc.12167","article-title":"Update on clubfoot","volume":"49","author":"Gibbons","year":"2013","journal-title":"J Paediatr Child Health"},{"key":"2022021323311750000_11.9.e049212.2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-009-0734-9"},{"key":"2022021323311750000_11.9.e049212.3","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1111\/tmi.12833","article-title":"Birth prevalence of congenital talipes equinovarus in low- and middle-income countries: a systematic review and meta-analysis","volume":"22","author":"Smythe","year":"2017","journal-title":"Trop Med Int Health"},{"key":"2022021323311750000_11.9.e049212.4","doi-asserted-by":"crossref","first-page":"e462","DOI":"10.1097\/BPO.0000000000001191","article-title":"Clubfoot etiology: a meta-analysis and systematic review of observational and randomized trials","volume":"38","author":"Chen","year":"2018","journal-title":"J Pediatr Orthop"},{"key":"2022021323311750000_11.9.e049212.5","doi-asserted-by":"publisher","DOI":"10.1542\/peds.113.2.376"},{"key":"2022021323311750000_11.9.e049212.6","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/j.rbo.2015.11.006","article-title":"Functional and clinical results achieved in congenital clubfoot patients treated by Ponseti\u2019s technique","volume":"51","author":"Jaqueto","year":"2016","journal-title":"Rev Bras Ortop"},{"key":"2022021323311750000_11.9.e049212.7","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1007\/s11832-015-0658-8","article-title":"Mid-Term results of a physiotherapist-led Ponseti service for the management of non-idiopathic and idiopathic clubfoot","volume":"9","author":"Dunkley","year":"2015","journal-title":"J Child Orthop"},{"key":"2022021323311750000_11.9.e049212.8","doi-asserted-by":"publisher","DOI":"10.1097\/00004694-200207000-00019"},{"key":"2022021323311750000_11.9.e049212.9","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.2106\/00004623-199510000-00002","article-title":"Treatment of idiopathic clubfoot. 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