Talipes equinovarus or Clubfoot: A review of study approaches, management and trends in Pakistan

Murtaza, Khadija; Saleem, Zahra; Malik, Sajid

doi:10.12669/pjms.36.6.2514

Cited by 4 publications

(9 citation statements)

References 11 publications

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“…Clubfoot, or congenital talipes equinovarus (CTEV), is the most common musculoskeletal birth anomaly, with an estimated 6000–7000 cases per year in Pakistan [ 1 ]. The incidence of clubfoot fluctuates around the world.…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of clubfoot fluctuates around the world. It has an incidence of 1.5 per 1000 live births in Pakistan [ 1 ], 0.9/1000 live births in India [ 2 ], 1/1000 live births in the USA [ 2 ], 0.87/1000 live births in Japan [ 2 ], and 3.49/1000 live births in Australia [ 2 ]. The male-to-female ratio is 2.5 to 2.8:1 [ 1 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of the Ponseti Technique in Different Types of Clubfoot—A Single Center Retrospective Analysis

Butt¹,

Perveen

Ciongradi

et al. 2023

Children

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Background: Clubfoot is a congenital deformity that can affect one or both of a newborn’s lower extremities. The main objective of the study is to evaluate and compare the outcomes of the Ponseti method for the management of different types of clubfoot. Methods: A retrospective analysis of 151 children with 253 clubfeet (idiopathic untreated, idiopathic recurrent, and syndromic) with at least one year of follow-up was conducted in four months after ethical approval. Data were collected with a structured proforma after the consent of the parents. An independent sample t-test was applied to show the comparison between the groups, and a p-value of 0.05 was considered significant. Results: Out of 151 patients, 76% were male and 24% were female. Out of a total of 235 feet, 96 (63%) were idiopathic untreated, 40 (26.5%) were idiopathic recurrent, and 15 (9.5%) were syndromic clubfoot. The average number of casts was higher in syndromic clubfoot (9 casts per foot). There was no significant difference in the baseline Pirani score of the three groups (p-value > 0.05); but after one year of follow-up, there was a significant difference in the Pirani score of idiopathic and syndromic clubfoot (p-value ≤ 0.05) and between recurrent clubfoot and syndromic clubfoot (p-value = 0.01). Conclusions: The aetiology of syndromic clubfoot affects the outcomes of the Ponseti method and leads to relapse. In idiopathic (untreated and recurrent) clubfoot, the Ponseti method does not produce a significant difference in outcome. Poor brace compliance and a lack of tenotomy lead to orthotic (ankle foot orthosis AFO and foot orthosis FO) use in the day time and the recurrence of clubfoot deformity in these three types of clubfoot.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Outcomes of the Ponseti Technique in Different Types of Clubfoot—A Single Center Retrospective Analysis

Butt¹,

Perveen

Ciongradi

et al. 2023

Children

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“…In Pakistan approximately 70,000 cases of Congenital talipes equinovarus are reported annually, and only 5-10 cases are treated on time with adequate necessary treatment. 7 This reported rate of treatment is below the standard requirement of treatment of children with this deformity.…”

Section: Introductionmentioning

confidence: 88%

“…However the introduction of Ponseti Method get popular and almost successfully replaced the other mode of treatments. 7,8 The Ponseti method use two phases including corrective phase (casting phase) in which the position of the foot is corrected step by step using a series of manipulations and casts and maintenance phase (Braching) where child's feet are put into a brace to maintain it in its correct position for long time. 9 This treatment approach is used with its standard operating time frame and method.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Accelerated vs Standard Ponseti Technique Among Children's Having Congenital Talipes Equinovarus

Rehman

Hussain²,

Ullah³

et al. 2022

J Ayub Med Coll Abbottabad

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Background: The resurgence and long duration of treatment of the Ponseti method in recent years has been punctuated by less than favourable long-term outcomes for surgically treated feet. Objectives of the study were to compare the two treatment techniques accelerated vs standard Ponseti technique among children’s having Congenital Talipes Equinovarus. Methods: This was two years randomized control trial study carried out among total 104 idiopathic congenital talipes equinovarus patients in Orthopaedics and Spine Unit, Hayatabad Medical Complex, Peshawar. A convenient sampling technique was used in this study. Informed written consent was taken from each respondent. Patients in group A was subjected to accelerated ponseti technique and patients in group B was subjected to standard ponseti technique. At one month after treatment, all the patients were re assessed on the basis of pirani score. Data was collected and analyzed using SPSS version 21. Results: This study included a total 104 clinically diagnosed Congenital Talipes Equinovarus patients with mean age 5.5±2.1 months and 52 in each treatment group. Out of total 104 patients 68 (65.4%) were male and 36 (34.6%) were female. They’re found significant difference in the mean ponseti scores of these two-group p=0.042 provided comparatively low mean pirani score in accelerated ponseti group. All female child in accelerated ponsati group was responded to the treatment with 100% effectiveness rate. The difference of effectiveness of treatment was significant p=0.015 for children age range 4–8 months divided in two treatment group with good effectiveness 80.8% in accelerated ponseti group. Conclusion: Accelerated ponseti technique is more effective than standard ponseti technique for Congenital Talipes Equinovarus.

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“…Clubfoot, or congenital talipes equinovarus, is the most frequently encountered congenital deformity involving the foot (1)(2)(3). It is a complex tridimensional deformity concerning hindfoot, midfoot and forefoot (1,2,4).…”

Section: Introductionmentioning

confidence: 99%

Clubfoot management in the Middle East: a survey-based review

Ghanem¹,

Rizkallah²

2021

Ann Transl Med

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Clubfoot is the most frequent congenital deformity involving the foot. Little is known about the management of this disease in the Middle East as sparse data is available in the literature. Through the last 5 decades, congenital clubfoot management in the Middle East went from manipulation through Kite's technique in the late seventies, to early primary surgical intervention in the late eighties and early nineties of the previous century, and then back to manipulation with Ponseti's technique and the French functional technique in the late nineties, with the latter falling out of favor with time. This is comparable to the evolution of management witnessed in the United States and in Europe, with 10 to 15 years of delay.The delay is getting shorter with time due to the easier access to published scientific data and the increasing number of fellows from Middle East travelling to referral centers in Europe and the USA. A survey was performed among pediatric orthopedic surgeons in the Middle East to assess their approach to clubfoot management. This is the first survey of its kind in the region. It showed a wide adoption (97.1%) of the Ponseti's technique with serial manipulation and casting, Achilles tenotomy followed by abduction bracing. Divergent practices were found concerning the upper age limit for Ponseti treatment and the setting of the Achilles tenotomy. Nevertheless, these subjects are still a matter of debate in the literature and international conferences. All in all, pediatric orthopedic surgeons in the Middle East are offering their patients the gold standard of care. However, lot of work is to be done in raising awareness for this disease in the community, and among our colleagues as prenatal screening for clubfoot in the Middle East is practically nonexistent.

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Talipes equinovarus or Clubfoot: A review of study approaches, management and trends in Pakistan

Cited by 4 publications

References 11 publications

Outcomes of the Ponseti Technique in Different Types of Clubfoot—A Single Center Retrospective Analysis

Outcomes of the Ponseti Technique in Different Types of Clubfoot—A Single Center Retrospective Analysis

Comparison of Accelerated vs Standard Ponseti Technique Among Children's Having Congenital Talipes Equinovarus

Clubfoot management in the Middle East: a survey-based review

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