DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20172876

Treatment of idiopathic clubfoot by Ponseti method: a prospective evaluation

Vijaykumar Kulambi, Subodh Shetty, Venkatesh Ghantasala, Vishwanath Bhagavati

Abstract


Background: From long time clubfoot has been a clinical challenge to orthopaedic surgeons. It is one of the commonest congenital deformity of the musculoskeletal system in children. Each year more than 1,00,000 babies are born with congenital clubfoot. 80% of which occur in developing countries.

Methods: 60 feet in 40 children were treated by the Ponseti method from September 2014 to august 2016. Prospective follow up for a mean duration of 18 months was undertaken. The deformity was evaluated by Pirani score before and after the treatment. At the end of treatment all feet were functionally classified into good, fair and poor.

Results: The average number of casts applied before full correction was 8. 21.66% of the feets needed tenotomy before full correction. 90% of the patients showed good results, 3.3% had fair results and 6.6% of patients had poor results. There was a significant difference in the pre-treatment and post-treatment pirani score values.

Conclusions: Ponseti method of manipulation and plaster casting is very effective to correct club foot deformity. 


Keywords


Clubfoot, Ponseti method, Pirani score, Tenotomy

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References


Cooper DM, Dietz FR. Treatment of idiopathic clubfoot: a thirty-year follow-up note. J Bone Joint Surg Am. 1995;77:1477-89.

Ponseti IV. The Treatment of Congenital Clubfoot. J Orthop Sports Physther. 1994;20(1):1.

Ponseti IV. Treatment of Congenital Clubfoot. J Bone Joint Surg Am. 1992;74(3):448-54.

Ponseti IV, Smoley EN. Congenital Clubfoot: The Results of Treatment. J Bone Joint Surg Am. 1963;45(2):2261-75.

Jekelj F, Ktazl D, Elmorej G. Epidemiology, Biostatistics And Preventive Medicine. 2nd edition. W.B. Saunders Company. 2001;173:177.

Ponseti IV. Correction of the Talar Neck Angle in Congenital Clubfoot with Sequential Manipulation and Casting. IOWA Orthop J. 1998;18:74-5.

Ponseti IV. Clubfoot Management. J Pediatr Orthop. 2000;20(6):699-700.

Brand RA, Laaveg SJ, Crowninshield RD, Ponseti IV. The center of pressure path in treated clubfoot. Clin Ortho Prelat Res. 1981;160:43-7.

Colburn M, Williams M. Evaluation of the treatment of idiopathic clubfoot by using the Ponseti method. J Foot Ankle Surg. 2003;42(5):259-67.

Cooper DM, Dietz FR. Treatment of idiopathic clubfoot: a thirty-year follow-up note. J Bone Joint Surg Am. 1995;77(10):1477-89.

Herzenberg JE, Radler C, Bor N. Ponseti versus traditional methods of casting for idiopathic clubfoot. J Pediatr Orthop. 2002;22(4):517-21.

Ippolito E, Farsetti P, Caterini R, Tudisco C. Long-term comparative results in patients with congenital clubfoot treated with two different protocols. J Bone Joint Surg Am. 2003;85(7):1286-94.

Laaveg SJ, Ponseti IV. Long-term results of treatment of congenital clubfoot. J Bone Joint Surg Am. 1980;62(1):23-31.

Cowell HR, Wein BK. Genetic aspects of clubfoot. J Bone Joint Surg Am. 1980;62(8):1381-4.

Yamamoto H. A clinical, genetic and epidemiologic study of congenital clubfoot. Jinrui Idengaku Zasshi. 1979;24(1):37-44.

Palmer RM. Genetics of Talipesequinusvarus. J Bone Joint Surg Am. 1964;46:542-56.

Morcuende JA, Abbasi D, Dolan LA, Ponseti IV. Results of an accelerated Ponseti protocol for clubfoot. J Pediatr Orthop. 2005;25(5):623-6.

MorcuendeJA, Dolan LA, Dietz FR, Ponseti IV. Radical reduction in the rate of extensive corrective surgery for clubfoot using the Ponsetimethod. Pediatrics. 2004;113(2):376-80.

Scher DM, Feldman DS, Van Bosse HJ, Sala DA, Lehman WB. Predicting the need for tenotomy in the Ponseti method for correction of clubfeet. J Pediatr Orthop. 2004;24(4):349-52.

Thacker MM, Scher DM, Sala DA, Van Bosse HJ, Feldman DS, Lehman WB. Use of the foot abduction orthosis following Ponseti casts: is it essential? J Pediatr Orthop. 2005;25(2):225-8.