2018•International Journal of Research in OrthopaedicsOpen access

Evaluation of Ponseti method in correction of congenital talipes equinovarus

Gopal Shinde, Yogesh A. Dhole, Manoj R. Kashid, Vijay Kakatkar, S. K.

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Abstract

Background: Congenital idiopathic clubfoot is a complex foot deformity often requires many months of treatment and frequently resulted in incomplete or defective correction by older methods. Deformity can be corrected with serial manipulation and casting with minimal or no surgery as reported by Ponseti. This study is an attempt to evaluate the effectiveness of Ponseti technique in treatment of idiopathic congenital talipes equino varus. Methods: 30 patients between age group of 01 to 24 weeks with 48 feet having congenital idiopathic clubfoot were treated using Ponseti technique. The guidelines for treatment were followed as per the Ponseti method of serial manipulation and casting at weekly intervals. Results: 43 (89.58%) cases were treated successfully by using Ponseti technique without need of extensive surgery. 42 feet required tenotomy. 38 (79.16%) feet had an excellent outcome, 5 (10.42%) feet had a fair outcome and 05 feet (10.42%) had poor outcome as measured by the Pirani scoring system. 7 (14.58%) patients had cast related complications. Conclusions: The Ponseti method is a safe, effective and reproducible method for correction of idiopathic congenital talipes equinovarus which significantly reduces the rate of extensive corrective surgeries for correction of clubfoot.

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Background: Congenital idiopathic clubfoot is a complex foot deformity often requires many months of treatment and frequently resulted in incomplete or defective correction by older methods. Deformity can be corrected with serial manipulation and casting with minimal or no surgery as reported by Ponseti. This study is an attempt to evaluate the effectiveness of Ponseti technique in treatment of idiopathic congenital talipes equino varus. Methods: 30 patients between age group of 01 to 24 weeks with 48 feet having congenital idiopathic clubfoot were treated using Ponseti technique. The guidelines for treatment were followed as per the Ponseti method of serial manipulation and casting at weekly intervals. Results: 43 (89.58%) cases were treated successfully by using Ponseti technique without need of extensive surgery. 42 feet required tenotomy. 38 (79.16%) feet had an excellent outcome, 5 (10.42%) feet had a fair outcome and 05 feet (10.42%) had poor outcome as measured by the Pirani scoring system. 7 (14.58%) patients had cast related complications. Conclusions: The Ponseti method is a safe, effective and reproducible method for correction of idiopathic congenital talipes equinovarus which significantly reduces the rate of extensive corrective surgeries for correction of clubfoot.

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Available abstract

Background: Congenital idiopathic clubfoot is a complex foot deformity often requires many months of treatment and frequently resulted in incomplete or defective correction by older methods. Deformity can be corrected with serial manipulation and casting with minimal or no surgery as reported by Ponseti. This study is an attempt to evaluate the effectiveness of Ponseti technique in treatment of idiopathic congenital talipes equino varus. Methods: 30 patients between age group of 01 to 24 weeks with 48 feet having congenital idiopathic clubfoot were treated using Ponseti technique. The guidelines for treatment were followed as per the Ponseti method of serial manipulation and casting at weekly intervals. Results: 43 (89.58%) cases were treated successfully by using Ponseti technique without need of extensive surgery. 42 feet required tenotomy. 38 (79.16%) feet had an excellent outcome, 5 (10.42%) feet had a fair outcome and 05 feet (10.42%) had poor outcome as measured by the Pirani scoring system. 7 (14.58%) patients had cast related complications. Conclusions: The Ponseti method is a safe, effective and reproducible method for correction of idiopathic congenital talipes equinovarus which significantly reduces the rate of extensive corrective surgeries for correction of clubfoot.

Key concepts: Ponseti method, Medicine, Tenotomy, Clubfoot, Congenital talipes equinovarus, Deformity, Surgery, Foot (prosody)

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