Management of clubfoot by ponseti method: A prospective study

Abstract

INTRODUCTION AND AIM: Clubfoot is usually diagnosed immediately after birth; hence, most of the surgeons believes in an early initiation of treatment. Thus, our study was aimed to assess the efficacy of Ponseti technique in correcting congenital talipes equinovarus deformity of foot, to determine the type of clubfoot best suited for this technique and to find the lacunae and disadvantages of Ponseti technique, if any. MATERIALS AND METHODS: It was a prospective study of 50 cases with 76 feet of clubfoot in tertiary level hospital from September 2012 to October 2016. All these cases included were classical clubfoot deformities (idiopathic clubfoot), excluding syndromic and complicated cases with previous failed operative treatment. Children were evaluated by Pirani severity scoring system. All the patients were treated by Ponseti technique of corrective casting and achilles tenotomy. RESULTS: In the present study, about 84% of patients had good results, 4% had fair results, and 12% of patients had poor results showing failure with Ponseti technique. Overall, 88% of the patients presented with satisfactory results. Overall, mean Pirani score for all the feet was 5.01. There were thirty complications among all the patients, constituting 39% of total feet. CONCLUSION: The observations of the present study clearly showed that age at initial presentation, quality (mobility) of foot and Pirani score at presentation directly affects final results. Ponseti technique for the treatment of clubfoot is a simple and effective which is suitable in the Indian subcontinent as it is economical.