Management of idiopathic congenital talipes equinovarus by standard versus accelerated Ponseti plaster technique: A prospective study

2015 ◽  
Vol 8 (1) ◽  
pp. 30 ◽  
Author(s):  
Biswajit Sahu ◽  
Rajesh Rajavelu ◽  
Barsha Tudu
Keyword(s):  
Prospective Study ◽  
Congenital Talipes Equinovarus ◽  
Talipes Equinovarus ◽  
Congenital Talipes ◽  
Accelerated Ponseti ◽  
A Prospective Study

scholarly journals Comparative analysis of correction of idiopathic congenital talipes equinovarus by conventional and accelerated Ponseti method with minimum 12 months follow up in a tertiary care hospital in North India

2021 ◽  
Author(s):  
Pankaj Vir Singh ◽  
Abdul Ghani ◽  
Tejpal Singh ◽  
Anzar Tariq Malik ◽  
Simranpreet Singh
Keyword(s):  
Tertiary Care ◽  
North India ◽  
Standard Group ◽  
Care Hospital ◽  
Congenital Talipes Equinovarus ◽  
Pirani Score ◽  
Talipes Equinovarus ◽  
Congenital Talipes ◽  
Accelerated Ponseti

Background: Congenital talipes equinovarus varus (CTEV) is one of the most common congenital anomalies of foot and ankle affecting 1/1000 live birth approximately. With a male dominance pattern, this deformity is bilateral in 50% cases. It has four basic components: cavus, adduction, varus and equinus. Severity of clubfoot is accessed using Pirani score (0 to 6). Insights into the basic pathoanatomy of this complex 3 dimensional deformity has helped to correct it using the method given by Ignacio Ponseti, a Spanish orthopaedician, in which serial manipulations of foot are done and weekly casts are applied, followed by a tendoachilles tenotomy in selected cases to correct the equinus component which is then followed by splintage of the feet in Steenbeek splint initially for 23 hours day for 3 months and then 12 hours a day for 3 years. The most important component of this treatment is parental counselling regarding the need for compliance with treatment which is often loophole responsible for relapse in initially corrected feet.Methods: This was a prospective study including 40 patients (61 feets) of idiopathic clubfoot with age <3 month at presentation who were randomly distributed in two groups, group 1 (accelerated Ponseti casting group) in which twice weekly casts were applied and group 2 (standard Ponseti casting group) in which weekly casts were applied. Initial Pirani score was calculated in all the patients and was rechecked and documented in every successive visit. All the patients were followed upto 12 months and there was no lost to follow up in this study.Results: The mean days of plaster duration in accelerated casting group was 18.45 days as compared to 47.25 days in standard casting group (statistically significant, p value <0.05). Also, Pirani score at the end of last follow up was comparable in both the groups. Tenotomy rate was slightly higher in accelerated casting group (89.5%) as compared to standard group (85.7%) which may be attributed to higher initial Pirani score in former (5.5) as compared to later (5.0).Conclusions: Accelerated biweekly Ponseti casting reduces the overall days of treatment with similar results compared to standard weekly casting regime.

scholarly journals Outcome of treatment with modified Ponseti technique in atypical congenital talipes equinovarus

2020 ◽  
Vol 9 (1) ◽  
pp. 53
Author(s):  
Sanjeev Gupta ◽  
Farooq Bhutt ◽  
Manoj Kumar ◽  
Maneer Ahmad
Keyword(s):  
Congenital Talipes Equinovarus ◽  
Easy Method ◽  
Functional Correction ◽  
Talipes Equinovarus ◽  
Dorsum Of Foot ◽  
Congenital Talipes ◽  
A Prospective Study ◽  
Study Participants ◽  
Lost To Follow Up

Background: The atypical congenital talipes equinovarus (CTEV) patients tend to have a different clinical foot presentation with small great toe, deep transverse crease of sole, tender swollen dorsum of foot and rigid equinus.Methods: This study was conducted in GMC Jammu to evaluate efficacy of modified Ponseti technique in atypical CTEV patients. It was a prospective study and the patient data was collected during OPD visits of patients from August, 2018 to June, 2020. Twenty-one patients were diagnosed as atypical CTEV and were managed with modification of conventional Ponseti technique and percutaneous release of achilles tendon was done in all patients. Three patients were lost to follow-up. Hence, the final number of study participants was 18 (n=18).Results: With modified Ponseti technique, functional correction was achieved in all the patients in our study. The average number of casts required was 8 (range; 5-10). At final follow-up visit, all feet are functionally corrected. Only one case of relapse was seen.Conclusions: Early diagnosis and treatment with modified Ponseti technique is an effective and easy method of treatment in atypical CTEV.

scholarly journals Accelerated versus standard Ponseti method for idiopathic congenital talipes equinovarus: a systematic review and meta-analysis

2021 ◽  
Vol 8 (4) ◽  
pp. 473-484
Author(s):  
Sherly Desnita Savio ◽  
Made Agus Maharjana
Keyword(s):  
Relapse Rate ◽  
Meta Analysis ◽  
Total Duration ◽  
Ponseti Method ◽  
Duration Of Treatment ◽  
Congenital Talipes Equinovarus ◽  
Post Procedure ◽  
Talipes Equinovarus ◽  
Congenital Talipes ◽  
Accelerated Ponseti

Background. The standard Ponseti method is a mainstay of treatment for children with congenital talipes equinovarus (CTEV); involving weekly manipulation and long-leg casting, this approach has proven to produce good long-term outcomes. However, it takes approximately 45 weeks to correct all deformity components, making compliance a challenge for patients with limited economic resources and difficulty reaching healthcare centres. Aim. This study aims to compare treatment outcomes between standard Ponseti and an accelerated protocol applying the same casts but changing them more frequently, every 2-5 days for the CTEV pathology. Methods. A systematic search was conducted based on PRISMA guidelines to identify relevant studies through PubMed, Google Scholar, and Cochrane Database. A total of seven studies (324 patients, 408 feet) were included in the meta-analysis. Five outcomes were compared between the two procedures: post-procedure Pirani score, relapse rate, tenotomy rate, number of casts, and total duration of treatment. Results. For total duration of treatment, the accelerated Ponseti method was superior to standard Ponseti (24.25 vs. 41.54 days, p 0.00001). On the other hand, it achieved comparable efficacy as measured by post-procedure Pirani score (1.01 vs. 0.87, p = 0.19). Furthermore, the two procedures were also comparable in terms of the total number of casts needed (4.94 vs. 5.05, p = 0.76), tenotomy rate (73.29% vs. 65.27%, p = 0.07) , and relapse rate (27.72% vs 25.23%, p = 0.56). Conclusion. Accelerated Ponseti offers similar efficacy and shorter duration of treatment compared to the standard Ponseti technique.

THE EVALUATION OF THE RESULTS OF NEGLECTED CLUBFOOT MANAGED BY PONSETI METHOD

2021 ◽  
pp. 23-25
Author(s):  
Nandram Saryam ◽  
Raja Yadav ◽  
Manish Rajpoot
Keyword(s):  
Ponseti Method ◽  
Effective Technique ◽  
Congenital Talipes Equinovarus ◽  
Medical College ◽  
Relapse Pattern ◽  
Study Results ◽  
Talipes Equinovarus ◽  
Gandhi Medical College ◽  
A Prospective Study ◽  
Foot Disorder

Background: Congenital talipes equinovarus is the most common congenital foot disorder. neglected of clubfoot deformity occurs after the treatment by Ponseti method .we evaluate the relapse pattern of clubfoot basis of bhasker et al then treat the patient by Ponseti technique. Methods: This is a Prospective study .We are conducting a clubfoot clinic since 2013 in Department of Orthopaedics Gandhi medical college Bhopal . We register all clubfoot patient at our clubfoot clinic on his/her rst visit. All the clubfeet assessed with Pirani scoring system on the initial presentation to our institution and treat by Ponseti method. During this study there were a total of 558 children with 713 idiopathic clubfeet registered at our clinic. A total of 80 neglected clubfeet in 56 children presenting with neglected clubfeet were included in our study. Results: We found that The neglected feet in our study is (80 feet out of 713 feet. The male patient is 38 (67.86%) and female patient is 18 (32.14%). Male were predominantly involved as compared to female.The post treatment Pirani score after relapse treatment is 0.40 Conclusion: Ponseti technique is a simple, effective, inexpensive method for treatment of clubfeet there is, no requirement of special setup with limited resources and less rate of recurrence/complication than the surgical treatment It has been concluded that Ponseti method is a effective technique to treat congenital idiopathic clubfeet with success rate is 94.65% in our study

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