Evaluation of outcome of treatment of idiopathic clubfoot by ponseti technique of manipulation and serial plaster casting

Abstract

Idiopathic clubfoot or congenital talipes equinovarus is the commonest congenital foot deformities having 1 in every 1000 children born worldwide. Around 80% of the cases occur in developing nations. It remains the most difficult to treat. The most widely used treatment is the Ponseti method of manipulation and serial plaster followed by an Achilles tenotomy. This method is effective in 90% of all cases. The objective of this study was to evaluate the outcomes of the Ponseti manipulation and casting method in the management of idiopathic clubfoot. This is a prospective study of 80 feet in 52 children treated by the Ponseti method in the department of Orthopedics, Rajendra Institute of Medical Sciences (RIMS), Ranchi, and Jharkhand. Evaluation of the deformity was done by Pirani score before and after the treatment and the results were assessed. The average number of castings used to correct the deformity was 6.5 times (range: 4 to 12). Tenotomy was performed in 66 (82.5%) of the feet. In all patients, plantigrade foot was achieved. The patients with bilateral clubfeet, higher Pirani score and higher age had inferior final outcome compared to those with unilateral clubfoot, lower Pirani score and lower age. 11 (13.75%) feet had skin excoriation secondary to cast problems and four patients had pain and tenderness at the site of the tenotomy. Recurrence was seen in three cases. 90.38% of parents were completely satisfied with their child's gait and foot appearance.

Órteses de EVA no tratamento para pé torto congênito em recém-nascidos

“…The newborns that received early intervention for congenital clubfoot improved only with conservative treatment. All the families were satisfied with the use of EVA when asked about the appearance of their newborn's foot, corroborating the results of Kumar, Suman and Manjhi (2017) and Kulambi et al (2017) These authors consider the conservative treatment a positive method for resolving the deformity and report that parents were satisfied with the appearance of their newborn's foot. Both describe the evolution of CC in pediatric patients after conservative treatment and serial plaster casting.…”

Clinical, Radiological, Pedobarographic, and Quality of Life Outcomes of the Ponseti Treatment for Clubfoot: A Prospective Study from Iran

“…In Azimi and Narouie's study of 32 clubfeet, the mean Pirani score dropped from 5.53 to 0.09 after 4 to 14 months of treatment, which was to be expected, given the scoring shortly after treatment [13]. Kumar et al have also reported a decrease in mean Pirani score from 5.3 to 0.8 following six to twenty months of Ponseti management [22].…”

Impact of guidance and telemonitoring on foot flexibility due to postural congenital clubfoot in the first month of life: a longitudinal descriptive study

“…Estratégias conservadoras são promissoras para o tratamento do pé torto congênito postural. 3,23,24 Além disso, o telemonitoramento oferece uma oportunidade única para o engajamento ativo dos pais durante o tratamento. Também serve como uma alternativa essencial para incentivar a participação da família e monitorar seu papel no cuidado e reabilitação de crianças com diversas condições de saúde, promovendo um senso de apoio e vínculo mesmo quando estão fisicamente distantes dos serviços de saúde.…”