Management of idiopathic clubfoot by Ponseti’s method: a comparative clinical study on toddlers with radiological correlation

Abstract

<p class="abstract"><strong>Background:</strong> In developed countries, many children with clubfoot undergo extensive corrective surgery, often with disturbing failures and complications. The need for one or more revision surgeries is common. Although the foot looks better after surgery, it is stiff, weak, and often painful. Non-operative treatment of clubfoot provides a lower complication rate, less pain, and higher function as the patient ages. Lack of information regarding reasons for adherence to the regimen makes it difficult for health providers and health planners to determine the impact of treatments on health status or weigh the cost/benefit ratio for prescribing costly treatments to the patients. Therefore, it is important to understand how parents and health care givers manage their children’s treatment and the potential barriers these parents encounter during the utilization of clubfoot treatment services. It is important to determine the compliance of patients to clubfoot correction treatment in order to identify and target factors that may positively or negatively influence cases attending the clinic.</p><p class="abstract"><strong>Methods:</strong> 25 cases with clubfoot were studied in the Department of Orthopaedics, Katihar Medical College. Out of these, 13 cases (Group A) were children over 1 year of age with neglected clubfoot and 12 cases (Group B) were children under one year of age with idiopathic clubfoot.<strong></strong></p><p class="abstract"><strong>Results:</strong> The Ponseti method delivers excellent correction of clubfoot without the associated risks and complications of major foot surgery. Patients treated with Ponseti’s method have leverage in treatment of clubfoot than those treated by other conservative methods. The method provides more flexible foot and ankle than those treated surgically.</p><p><strong>Conclusions:</strong> Treatment of clubfoot if commenced early will have better result. Children of age less than 1 year respond better than children of older age group. Younger children require fewer correction casts.</p>

Determination of the Effective Site for Percutaneous Achilles Tenotomy in Ponseti Management of African Idiopathic Clubfoot

“…Hence, the ultrasonographic field of view for the tendon evaluation was limited to this portion of the AT. Some authors perform the Achilles tenotomy 1 cm 17,18 and some 2 cm 19,20 proximal to its calcaneal insertion. Therefore, in this study, these two sites were considered for measurement of the thickness of the AT for comparison and then to know the thinnest portion of the AT.…”

Outcome of clubfoot treatment in the pre-ponseti period in a Nigerian teaching hospital: a 14 year review

“…It is also economical when compared to the hitherto prevalent surgery-based care and it is effective, safe, quick and easy to learn. 10,11 The first Ponseti clubfoot management workshop in Nigeria was held in Ile-Ife in December 2009. 11,12 One of the aims of the workshop is to build the capacity of local medical personnel on the use of Ponseti's method.…”