Author(s): Gautam Choudhury1, Manabjyoti Talukdar2
Long-term success reports by Dr. Ponseti with the Ponseti method in the treatment of congenital idiopathic clubfoot have led to a renewed interest in this method among paediatric orthopaedists.
The purpose of this study is to evaluate mid-term effectiveness of Ponseti method for the treatment of congenital idiopathic clubfoot.
MATERIALS AND METHODS
Of 93 babies (26 girls, 67 boys) with idiopathic clubfoot who began treatment at Assam Medical College and Hospital between April 2014 and June 2016. 85 patients (22 girls and 63 boys) with 127 clubfeet (71 right feet, 56 left feet) were included in the study. 42 cases were bilateral and 43 were unilateral. Minimum age 6 days and maximum age 3 years (SD 0.64 years). Presentation was categorised as either early or late. 26 (30.59%) of 85 babies who presented for treatment were 28 days or younger versus 59 (69.41%) of 85 babies who presented for treatment were late presenters.
Mean no. of cast required was 5.1. 26 feet (20%) did not require Achilles tenotomy. Higher initial severity scores at presentation were associated with the need for tenotomy. 31 (36%) had poor brace use and 54 (63%) had good brace use. Of 26 babies who presented early for treatment (28 days or younger), 11 (42.3%) had poor brace use and 15 (57.7%) had good brace use. However, in 59 babies who presented late, a larger percentage had good brace use (39 babies) than poor brace use (20 babies). No additional surgery was required for 60% of the brace intolerant patients. Final dorsiflexion was adequate for 117 (92%) of 127 feet. The final ankle motion (i.e., plantar flexion, dorsiflexion) was no different between early and late presenters.
Ponseti method is a safe and satisfactory treatment for congenital idiopathic clubfoot with mid-term effectiveness.