Recurrence of Deformity in Idiopathic Ctev Treated by Ponseti Technique

Abstract

Congenital talipes equinovarus (CTEV) or clubfoot, is one of the commonest congenital deformity . At present ,Ponseti method is most commonly used successful reliable , essentially conservative technique for correction of CTEV deformity and successful in upto 98% of feets. However there is a chance of the relapse or recurrence . A prospective and observational study after getting institutional ethical clearance was conducted in the department of Orthopedics, at COM and JNM Hospital, Kalyani, Nadai, WB, between August 2018 to July , 2020 including baby with club foot . Total study sample size was 20 according to inclusion and exclusion criteria. The mean age of presentation was 4 ± 2.51 week . The male to female ratio was 1.86:1. Bilateral feet involvement was 50% . In unilateral involvement , right side was affected 70%, left side was affected in 30 % cases. Family history of CTEV was seen in 20% cases. Mean body weight of babies was 2.49 ± 0.17kg . At presentation , mean pirani score was 5 ± 0.48. Tenotomy was done 75% cases . Relapse rate was 15 %, mean age of relapse was 7 ± 1.73205 month , occurred in most common in left side (66%). There was history of non-adherence of abduction brace for >2 month in all three patients adduction score was 0.5 in all child . Most common deformity relapse was adduction of forefoot. Ponseti method is cost effective especially in developing country . Strict adherence to brace protocol and good communication between heath care persons and parents reduces incidence of relapse. Relapse is relatively common even in Ponseti method and most of cases , it manageable by conservative treatment like cast.