Management of idiopathic clubfoot by Ponseti’s technique

Abstract

Background and objective: Idiopathic Congenital Talipes Equinovarus (CTEV) is a complex deformity that is difficult to correct. The treatment of clubfoot is controversial and continues to be one of the biggest challenges in paediatric orthopaedics. Most orthopaedicians agree that the initial treatment should be non-surgical and should be started soon after birth. We aimed to study a short term follow up Children included in the study were assessed for the severity of the deformity using the Pirani severity scoring system and clinical photographs were obtained. Casting of the foot was started by the technique described by Ponseti. Before cast placement every week, the foot deformity severity was assessed using the Pirani scoring system. These patients were followed up in a prospective manner for a period of minimum of six months. Results: At 6 months' follow-up, Ponseti's technique gave us 64.86% excellent results, 29.72% good results and a 5.4% poor results. 43.24 % required pecutaneous tenotomy, while 56.76% did not require tenotomy. There was an incidence of 8.1% for postero-medial soft tissue release. Interpretation and conclusion: The Ponseti method is a safe and cost effective treatment modality for congenital idiopathic clubfoot which gives excellent results, and radically decreases the need for extensive corrective surgery.

The Efficacy of the Ponseti Method in the Management of Clubfoot: A Systematic Review

“…This systematic review included nine studies that met the inclusion criteria [14][15][16][17][18][19][20][21][22] (Table 1). Two studies did not report the study design [21,22].…”

“…This systematic review included nine studies that met the inclusion criteria [14][15][16][17][18][19][20][21][22] (Table 1). Two studies did not report the study design [21,22]. While most of the studies were prospective [15,16,17,18], one was descriptive-retrospective [14], one was retrospective [19], and one employed a cross-sectional design [20].…”

“…Two studies categorized patients into two groups based on their age; the younger group, which involved children aged less than two years [18] or infants aged less than 30 days [19]; and the older group, which included children aged two to five years [18] or infants who started treatment after 30 days [19]. The overall success rate was reported in eight studies, whereas only one study categorized the success rate [22]. The overall success rate ranged between 55% [18] and 100% [15,19].…”

Effect of nursing instructions for mothers on selected cast outcomes among their infants with congenital clubfoot

“…These results were supported by [3] they studied the treatment of congenital clubfoot and found that 45% of infants their age were four months and the mean aged was 1.62 ± 0.898 months. As well as, [14] . They concluded that 64.86% of infants in six months and less than six months of follow-up to Ponseti's technique had excellent results.…”

Congenital Talipes Equinovarus (CTEV)

“…Dewasa ini umumnya bedah ortopedi sepakat bahwa terapi inisial untuk CTEV harus dimulai dengan metode non-operatif sejak hari pertama kehidupan agar deformitas dapat dengan mudah dikoreksi re-alignment, mendapatkan hasil fungsional yang baik, dan mencegah terjadinya relaps. 4 Mengingat bahwa defek ini memiliki keterlibatan genetik dan memerlukan penanganan sedini mungkin maka penulis tertarik untuk menelusuri lebih lanjut baik dari aspek pencegahan yang dapat dikaitkan pada marriage counseling, maupun persiapan orang tua sejak masa prenatal, penanganan dini, dan rekonstruksi operatif lanjut agar dapat menjamin quality of life (QoL) yang layak.…”