scholarly journals Assessment of Ponseti technique of manipulation and serial casting in idiopathic clubfoot

2019 ◽  
Vol 5 (2) ◽  
pp. 248
Author(s):  
Asif Hussain Khazi Syed ◽  
Kiran Kumar Koppolu Kanthi ◽  
Yakub Baroothu ◽  
Lalith Mohan Chodavarapu
Keyword(s):  
Treatment Protocol ◽  
Ponseti Method ◽  
Foot Deformities ◽  
Idiopathic Clubfoot ◽  
Congenital Talipes Equinovarus ◽  
Pirani Score ◽  
Serial Casting ◽  
Talipes Equinovarus ◽  
Full Correction ◽  
Time Of Presentation

<p class="abstract"><strong>Background:</strong> Congenital talipes equinovarus is one of the commonest congenital foot deformities. Ponseti technique of treatment of clubfoot has gained popularity in the last few decades. Feet treated by Ponseti technique are supple, flexible and pain free. We have treated congenital idiopathic clubfoot with Ponseti technique at our institute and present our results.</p><p class="abstract"><strong>Methods:</strong> Forty eight feet in thirty children with clubfoot were treated by Ponseti technique in our institute. The study was conducted from December 2013 to December 2015. Parents were counselled regarding treatment protocol and maintenance with bracing was closely monitored. Each child was followed up for a minimum of six months. Pirani score was used to objectively document progress of treatment.<strong></strong></p><p class="abstract"><strong>Results:</strong> The average number of casts required for complete correction was 6.6. 38% feet required tendoachilles tenotomy. Higher the initial Pirani score, more number of casts were required to achieve full correction. Number of casts needed for complete correction did not correlate to time of presentation.</p><p class="abstract"><strong>Conclusions:</strong> Ponseti method is very effective in correcting congenital idiopathic clubfoot deformity. It’s easy to learn, is inexpensive and can completely correct the deformity. In developing nations, well trained Orthopaedic surgeons can treat these children effectively and decrease disabled population.</p><p class="abstract"> </p>

MANAGEMENT OF IDIOPATHIC CONGENITAL CLUBFOOT USING PONSETI METHOD

2021 ◽  
pp. 38-39
Author(s):  
Chunchesh MD Chunchesh MD ◽  
Vani Ahuja ◽  
Kiran S Mahapure
Keyword(s):  
Cost Effective ◽  
Ponseti Method ◽  
Foot Deformities ◽  
Idiopathic Clubfoot ◽  
Congenital Talipes Equinovarus ◽  
Cost Effective Treatment ◽  
Pediatric Orthopaedics ◽  
Talipes Equinovarus ◽  
Main Factor

Introduction: Idiopathic congenital talipes equinovarus is a complex deformity that is difcult to correct. The treatment of clubfoot is controversial and continues to be one of the biggest challenges in pediatric orthopaedics. Most orthopedists agree that the initial treatment should be non-surgical and should be started soon after birth. We aimed to study a short-term follow up of 30 patients treated by the Ponseti method at our institute to assess the efcacy of the treatment modality. Methodology: 30 patients underwent Ponseti method for a period of 2 years, patients were followed up regularly at weekly intervals. The severity of foot deformities was graded as per Pirani's scoring system. Results: The Ponseti method is a safe and cost-effective treatment for congenital idiopathic clubfoot and radically decreases the need for extensive corrective surgery. Non-compliance with orthotics has been widely reported to be the main factor causing failure of the technique. At the end of study good results were obtained in 28 patients. 2 patients developed recurrence of the deformity due to non-compliance of the use of Orthotics.

scholarly journals RESULTS OF TREATMENT OF IDIOPATHIC CONGENITAL CLUBFOOT IN CHILDREN: A 3-YEAR FOLLOW UP STUDY

2020 ◽  
Vol 73 (12) ◽  
pp. 2640-2643
Author(s):  
Oleksii O. Holubenko ◽  
Anatolii F. Levytskyi ◽  
Oleksandr V. Karabenyuk
Keyword(s):  
Soft Tissue ◽  
Recurrence Rate ◽  
Primary Treatment ◽  
Nonparametric Tests ◽  
Ponseti Method ◽  
Soft Tissue Release ◽  
Idiopathic Clubfoot ◽  
Results Of Treatment ◽  
Pirani Score ◽  
Serial Casting

The aim: Was to analyze the outcome, recurrence rate and complications between Ponseti method and soft-tissue release 3 yearsafter the initial treatment. Materials and methods: This prospective cohort study was conducted in congenital idiopathic clubfoot patients who underwent primary treatment by either Ponseti serial casting or soft tissue release between 2006 to 2016 at department of traumatology and orthopedics National Children’s Specialized Hospital “Okhmatdet”. Total of 113 feet in 95 patients (61 males and 34 females), sixty-two feet (62 patients) were in the Ponseti group and thirty-three feet (33 patients) were in the surgical treatment group. For both groups, descriptive statistics were calculated Pirani score (2004) result before and 3 years after treatment, recurrence rate and complications. The comparison of the Pirani score result and complications between the two groups was analyzed by nonparametric tests (Mann-Whitney U-tests). Statistical data processing was performed in SPSS 17.0 program. Results: The results of Pirani score reveal satisfactory outcomes for both groups. But Ponseti method has the more conservative approach and lower complication rate (11,29±5,27% and 24,24±11,74%, p=0,52). Conclusions: Ponseti method is a safe, effective method for treatment of congenital idiopathic clubfoot in children from first days after birth. Open surgery should be reserved for deformity that cannot be completely corrected or for treatment of recurrences.

scholarly journals Management of idiopathic clubfoot with Ponseti technique

2017 ◽  
Vol 5 (8) ◽  
pp. 3355 ◽  
Author(s):  
Sumeet Singh Charak ◽  
Khalid Muzafar ◽  
Omeshwar Singh
Keyword(s):  
Effective Treatment ◽  
Club Foot ◽  
Ponseti Method ◽  
Idiopathic Clubfoot ◽  
Corrective Surgery ◽  
Congenital Talipes Equinovarus ◽  
Talipes Equinovarus ◽  
The Mean ◽  
Congenital Talipes ◽  
Main Factor

Background: Idiopathic congenital talipes equinovarus (club foot) is a complex deformity that is difficult to correct. The goal of treatment is to reduce or eliminate its four components so that the patient has a functional foot and leads a normal life.Methods: Study have treated 20 patients with 32 idiopathic clubfoot deformities using Ponseti method. The severity was assessed by modified pirani scoring.Results: The mean number of casts that were applied to obtain correction was 7.02 (range four to nine casts). Tenotomy was done in 30 feet. Thirty feet had good results. One patient developed recurrence of the deformity due to non-compliance of the use of orthrotics.Conclusions: The Ponseti method is a safe and effective treatment for congenital idiopathic clubfoot and radically decreases the need for corrective surgery. Non-compliance with orthotics main factor causing failure of the technique.

Congenital talipes equinovarus

2019 ◽  
Vol 101-B (6) ◽  
pp. 639-645 ◽  
Author(s):  
Y. Gelfer ◽  
S. Wientroub ◽  
K. Hughes ◽  
A. Fontalis ◽  
D. M. Eastwood
Keyword(s):  
Systematic Review ◽  
Ponseti Method ◽  
Assessment Methods ◽  
Major Surgery ◽  
Idiopathic Clubfoot ◽  
Congenital Talipes Equinovarus ◽  
Talipes Equinovarus ◽  
Minor Surgery ◽  
Meta Analyses

AimsThe Ponseti method is the benchmark treatment for the correction of clubfoot. The primary rate of correction is very high, but outcome further down the treatment pathway is less predictable. Several methods of assessing severity at presentation have been reported. Classification later in the course of treatment is more challenging. This systematic review considers the outcome of the Ponseti method in terms of relapse and determines how clubfoot is assessed at presentation, correction, and relapse.Patients and MethodsA prospectively registered systematic review was carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies that reported idiopathic clubfoot treated by the Ponseti method between 1 January 2012 and 31 May 2017 were included. The data extracted included demographics, Ponseti methodology, assessment methods, and rates of relapse and surgery.ResultsA total of 84 studies were included (7335 patients, 10 535 clubfeet). The relapse rate varied between 1.9% and 45%. The rates of relapse and major surgery (1.4% to 53.3%) and minor surgery (0.6% to 48.8%) both increased with follow-up time. There was high variability in the assessment methods used across timepoints; only 57% of the studies defined relapse. Pirani scoring was the method most often used.ConclusionRecurrence and further surgical intervention in idiopathic clubfoot increases with the duration of follow-up. The corrected and the relapsed foot are poorly defined, which contributes to variability in outcome. The results suggest that a consensus for a definition of relapse is needed. Cite this article: Bone Joint J 2019;101-B:639–645.

scholarly journals Ponseti method for treatment of idiopathic congenital talipes equinovarus at tertiary care center in India

2021 ◽  
Author(s):  
Maruti B. Lingayat ◽  
Sourabh S. Dhamale ◽  
Gaurav B. Mate
Keyword(s):  
Low Income ◽  
Care Center ◽  
Tertiary Care ◽  
Ponseti Method ◽  
Success Rates ◽  
Congenital Talipes Equinovarus ◽  
Achilles Tenotomy ◽  
Serial Casting ◽  
Foot Biomechanics ◽  
Talipes Equinovarus

<p class="abstract"><strong>Background:</strong> Different treatment methods were tried with variable success rates but Ponseti method of serial casting and manipulation stood apart due to better understanding of foot biomechanics and became accepted choice of treatment worldwide.</p><p class="abstract"><strong>Methods:</strong> 50 patients were enrolled in the study out of which 40 were available for final follow-up. We studied 40 cases during October 2018 to December 2020 at Government Medical College, Aurangabad. Out of 40 cases 31 were male and 9 were female. 25 were unilateral and 15 were bilateral. All cases were idiopathic. 4 inches Plaster of Paris (POP) bandages were cut into half and such 2 inches POP bandages were used for casting. Tenotomies were performed under controlled environment of Operation Theater with general anaesthesia. Number 12 surgical blade was used. Dennis-Browne splint was used for maintenance of correction.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of total 55 feet studied, 10 feet (18.18%) required tendo Achilles tenotomy and 45 feet (81.82%) were treated with casting alone. There were 8 cases of relapses (20%). All relapsed cases were treated with repeat casting as per Ponseti protocol and none of them required repeat tenotomy. Complications related to plaster were minimal and there were no incidence of rocker bottom deformity.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that in a low income developing country like India where case load is very high; Ponseti method is effective, inexpensive form of treatment with minimal complications. Need for extensive soft tissue procedures vastly reduced with this method.</p>

scholarly journals OUTCOME OF PONSETI METHOD IN TREATING CONGENITAL IDIOPATHIC CLUBFOOT: FIVE YEARS’ EXPERIENCE AT A TERTIARY HOSPITAL

2018 ◽  
Vol 11 (4) ◽  
pp. 118
Author(s):  
Edewet Daun ◽  
Mohd Yazid Bajuri ◽  
Abdul Halim Abd Rashid ◽  
Sharaf Ibrahim ◽  
Srijit Das
Keyword(s):  
Scoring System ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Ponseti Method ◽  
Idiopathic Clubfoot ◽  
Cross Sectional ◽  
Serial Casting ◽  
Talipes Equinovarus ◽  
Clinical Scoring ◽  
Paediatric Orthopaedic

 Objective: The earliest non-surgical treatment for the correction of congenital idiopathic talipes equinovarus (CTEV) deformity was described by Ignacio Ponseti. He suggested gentle manipulation and serial applications of casts followed by a period of bracing to maintain the correction. The main objective of this study was to evaluate the result of the Ponseti method with a subjective clinical scoring system using Pirani score, to compare the results with the published literature and to evaluate the effectiveness of foot abduction orthosis (FAO) or ankle-foot orthoses (AFO) in preventing relapse following correction.Methods: A cross-sectional study which was conducted at the Paediatric Orthopaedic Clinic, Universiti Kebangsaan Malaysia Medical Centre (UKMMC). A minimum of 12 months follow-up casting was observed before the patient was subjected to the subjective clinical scoring system. A total of 25 patients which included 5 right feet, 9 left feet, and 10 bilateral feet with idiopathic clubfeet were treated with Ponseti serial casting. Percutaneous Achilles tendon tenotomy was done for 28 feet (82.35%) to correct the equinus to achieve full correction.Results: Our results showed that the Ponseti method for treating CTEV was comparable to other published studies. Satisfactory and good results were observed in 97% of cases. A total of 41.18% underwent re-tenotomy of tendon Achilles due to recurrent and persistent equinus.Conclusion: The treatment of CTEV using Ponseti method will increase the successful correction. Meanwhile, the FAO gave better results for maintenance and prevention of recurrent deformity, compared to the AFO.

scholarly journals Does idiopathic congenital talipes equinovarus have an impact on attainment of developmental milestones? A multicentre international study

2019 ◽  
Vol 13 (4) ◽  
pp. 353-360 ◽  
Author(s):  
K. Hughes ◽  
Y. Gelfer ◽  
M. Cokljat ◽  
S. Wientroub ◽  
A. Yavor ◽  
...  
Keyword(s):  
Treatment Compliance ◽  
Ponseti Method ◽  
Idiopathic Clubfoot ◽  
Inclusion Criteria ◽  
Developmental Milestones ◽  
Congenital Talipes Equinovarus ◽  
Group I ◽  
Significant Difference ◽  
Talipes Equinovarus ◽  
Congenital Talipes

Purpose The Ponseti method is a well-established approach to treating clubfoot. Potentially, both the underlying pathology and adherence to post-correction bracing can affect lower limb function and age of independent standing and walking. This cohort study investigates the age at which infants with idiopathic clubfoot treated using the Ponseti method achieved three selected developmental milestones and whether or not this correlated with treatment compliance. Methods A prospectively collected database from four centres was visited. Inclusion criteria were patients with idiopathic clubfoot with no comorbidities or prior treatment. Age at attainment of independent standing, walking, nocturnal continence was compared across three groups: I) congenital talipes equinovarus (CTEV) children compliant with treatment; II) CTEV children non-compliant with treatment; and III) typically-developed siblings. Minimum follow-up was five years. Results In all, 130 patients (198 feet) fitted the inclusion criteria: 43:87 (F:M). Standing was achieved by a mean 12.0 months in group I (sd 2.50); 12.0 months (sd 2.0) in II and ten months (sd 3.0) in III. Walking was achieved by a mean 15 months (sd 4.0) in group I, 14 months (sd 1.75) in II and 12 months (sd 3) in III, respectively. Both the compliant and non-compliant CTEV children were significantly slower at achieving standing and walking compared to sibling controls (p < 0.0001). There was no significant difference between age of nocturnal continence between the three groups. Conclusion Infants with idiopathic clubfoot treated according to the Ponseti method achieve independent standing and walking approximately two months later than their typically-developed siblings. The delay is not related to the use of the foot abduction brace. Level of evidence: III

scholarly journals Evaluation of Ponseti method in correction of congenital talipes equinovarus

2018 ◽  
Vol 4 (2) ◽  
pp. 238
Author(s):  
Gopal M. Shinde ◽  
Yogesh A. Dhole ◽  
Manoj R. Kashid ◽  
Vijay R. Kakatkar ◽  
S. K. Rai
Keyword(s):  
Ponseti Method ◽  
Idiopathic Clubfoot ◽  
Age Group ◽  
Foot Deformity ◽  
Congenital Talipes Equinovarus ◽  
Excellent Outcome ◽  
Talipes Equinovarus ◽  
Reproducible Method ◽  
Congenital Talipes ◽  
Extensive Surgery

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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.<strong></strong></p><p class="abstract"><strong>Results:</strong> 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.</p><p><strong>Conclusions:</strong> 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.</p>

scholarly journals Comparative analysis of weight-bearing function of lower extremities in children with recurrences of congenital equinovarus clubfoot after surgical treatment by «traditional» methods and Ponseti method

2021 ◽  
pp. 9-17
Author(s):  
Sergij Khmyzov ◽  
Genadij Kykosh ◽  
Olena Karpinska ◽  
Mykhaylo Karpinsky
Keyword(s):  
Surgical Treatment ◽  
Weight Bearing ◽  
Ponseti Method ◽  
Foot Deformities ◽  
Traditional Methods ◽  
Congenital Talipes Equinovarus ◽  
Initial Surgery ◽  
Group I ◽  
Talipes Equinovarus ◽  
Group Ii

Congenital equinovarus clubfoot (EVC) is the second most common congenital anomaly of the musculoskeletal system in children and one of the most common causes of childhood disability in Ukraine. The frequency of EVC reaches 1–3 cases per 1 000 newborns (35–40 % of all foot deformities). Objective. To determine the features of the children ability with EVC recurrences, before and after surgical treatment by «traditional» methods and Ponseti method. Methods. Biomechanical examinations of 65 children with EVC recurrences were performed. They were divided into two groups: group I (33 patients) — treated by «traditional» methods, which provided initial surgery, in order to completely correct all components of the deformity; group II (32 patients) — treatment by Ponseti method. Weight-bearing function was studied for all patients, before treatment, after 6 and 12 months after surgery, with statography. Results. It was determined that the standing parameters in the groups were not statistically different. After 6 months after the treatment, according to the statograms, the weight-bearing displacement remained, under the conditions of two weight-bearing standing towards the contralateral limb, in both groups of patients. In group I, after treatment, this parameter did not change (p = 0.924), and in group II it decreased by (2.7 ± 4.7) % (p = 0.013). Weight-bearing on the operated limb in both groups, in 12 months from surgery increased by 45 %. Conclusions. In patients, after treatment of EVC recurrences by Ponseti method, the weight-bearing function indicators, in the case of two weight-bearing standing, changed statistically significant. During the recovery process, when patients began to load the operated foot, a slight deterioration of standing parameters was observed in patients of group I in 6 months from surgery. In patients of group II, a complete restoration of statographic parameters occurred earlier, in 6 months, a normalization of weight-bearing and stability was observed. Thus, it can be argued that the use of Ponseti method in the complex treatment of EVC allows to restore the ability of weight bearing much earlier than with the «traditional» method. Key words. Congenital talipes equinovarus, children, Ponseti method, statography.

scholarly journals Results of Ponseti Casting for Clubfoot in a Tertiary Public Hospital

2021 ◽  
Vol 55 (3) ◽  
Author(s):  
Ilian Dominiq D. Eusebio ◽  
Carlo Emmanuel J. Sumpaico
Keyword(s):  
Third World ◽  
Public Hospital ◽  
The Philippines ◽  
Ponseti Method ◽  
Idiopathic Clubfoot ◽  
Early Age ◽  
Congenital Talipes Equinovarus ◽  
Talipes Equinovarus ◽  
Congenital Talipes ◽  
Poor Outcomes

Introduction. Congenital talipes equinovarus (CTEV), also called clubfoot, is one of the most common orthopedic congenital anomalies. However, there is no formal study of the condition here in the Philippines, and data is sparse regarding the epidemiology, treatment, and outcomes in similar third-world countries. Methods. Retrospective review of data of clubfoot patients seen at the Philippine General Hospital (PGH) Clubfoot Clinic from 2006 up to the present. Results. Records from 75 patients treated at the PGH Clubfoot Clinic from 2010-2016 were reviewed. Idiopathic clubfoot comprised 76% of the patients, while syndromic clubfoot comprised 24%. A good outcome of the Ponseti method was seen in 82% and 88% of the idiopathic and syndromic clubfoot patients, respectively. Idiopathic clubfoot cases that had good outcomes required an average of 11.84 casts to tenotomy or bracing, which was not statistically significant compared to 9.55 average sessions for syndromic clubfoot (p=0.21). The initial Pirani scores for both cases were not significantly different (p=0.95). Idiopathic cases with poor outcomes needed less casting sessions (4.45) because the decision to operate was made early. Age was not found to significantly affect the outcome of treatment for idiopathic clubfoot (p=0.20) and syndromic clubfoot (p=0.64). Conclusion. Ponseti casting was found to be effective in treating both idiopathic and syndromic clubfoot patients. The number of sessions did not differ significantly between the two.

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