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.

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.

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 Accelerated versus conventional Ponseti protocol for the treatment of idiopathic talipes equinovarus deformity: A short term follow up in Iraq

2021 ◽  
Vol 25 (1) ◽  
pp. 473-479
Author(s):  
Jagar Doski ◽  
Berivan Jamal
Keyword(s):  
Ponseti Method ◽  
Congenital Talipes Equinovarus ◽  
Talipes Equinovarus ◽  
The Mean ◽  
Congenital Talipes ◽  
The Difference ◽  
Group 2 ◽  
Accelerated Protocol ◽  
Group 1

Background and objective: The accelerated protocol of Ponseti method was suggested to shorten the period of treatment of the conventional one for the cases of talipes equinovarus deformity. This study aimed to compare the accelerated protocol of Ponseti method in the treatment of clubfoot deformity with the conventional one. Methods: A prospective comparative study was conducted for infants less than six months with congenital talipes equinovarus deformity. The patients were randomized to either Group 1 (casts changed every week, conventional protocol of Ponseti method) or Group 2 (twice weekly, accelerated one). Pirani score was used to assess the severity of the deformity at presentation, at time of last cast removal, and at the last follow up visit (6th months). Results: The patients included were 48 cases with 79 feet. Group 1 (39 clubfeet) had a mean Pirani score of 5.6 (± 1.15) at presentation, which dropped to 0.47 (± 0.41) when the last cast was removed. In Group 2 (40 clubfeet), it dropped from 5.57 (± 0.83) to 0.77 (± 0.01). The result of each treatment protocol was significant, but the difference between them was not significant. Five cases (three patients aged more than three months) of Group 2 needed eight casts to reach an acceptable position of correction. The difference between the mean number of casts applied in Group 1 (5.09) and Group 2 (5.82) was statistically not significant. However, the difference between the mean number of days spent in the cast was significant. The complications occurred in 12 out of 79 feet, with no statistically significant difference between both groups. Conclusion: The accelerated protocol of Ponseti method for treating clubfoot deformity is as effective and as safe as the conventional one. It shortens the time required to complete the treatment program. Those who present lately (beyond the age of three months) may require an additional number of casts. Keywords: Clubfoot; Congenital talipes equinovarus; Ponseti; Accelerated; Cast.

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 Talipes equinovarus or Clubfoot: A review of study approaches, management and trends in Pakistan

2020 ◽  
Vol 36 (6) ◽  
Author(s):  
Khadija Murtaza ◽  
Zahra Saleem ◽  
Sajid Malik
Keyword(s):  
Large Scale ◽  
Scientific Evidence ◽  
Basic Research ◽  
Population Based ◽  
Ponseti Method ◽  
Congenital Talipes Equinovarus ◽  
Public Health Action ◽  
Creative Commons ◽  
Talipes Equinovarus ◽  
Congenital Talipes

This paper aims to assess the status of scientific literature on talipes equinovarus (TEV) published from Pakistan, to get an insight into the trend in knowledge over the years, and to highlight study gaps in this area. A detailed review of published literature was conducted from November 2019 to January 2020. ‘Talipes/congenital talipes’, ‘clubfoot/congenital clubfoot’, ‘talipes equinovarus /congenital talipes equinovarus’ AND ‘Pakistan’ were used as key terms. Different search engines, PubMed, PakMediNet, ScienceDirect, Embase and Google Scholar were utilized to retrieve articles. A total of 63 articles were retrieved. The hotspot of TEV research in Pakistan has been its treatment and management. Over the years, treatment trend has shifted from operative to conservative; Ponseti method is predominantly employed. Hospital-based studies focusing on pediatric patients are common while population-based studies are devoid. In majority of cohorts, there is preponderance of male patients, idiopathic and unilateral cases. There is, however, scarcity of basic research on the prevalence, etiology, risk factors, clinical heterogeneity, associated anomalies, genetics, and molecular diagnostics of TEV. In conclusion, prudent scientific evidence is required for any policy-making and relevant public health action. Hence, large scale population-based studies are required for a broader overview and understanding the clinical spectrum of TEV. doi: https://doi.org/10.12669/pjms.36.6.2514 How to cite this:Murtaza K, Saleem Z, Malik S. Talipes equinovarus or Clubfoot: A review of study approaches, management and trends in Pakistan. Pak J Med Sci. 2020;36(6):---------. doi: https://doi.org/10.12669/pjms.36.6.2514 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Congenital talipes equinovarus

2011 ◽  
Author(s):  
Michael Uglow
Keyword(s):  
Antenatal Diagnosis ◽  
Primary Treatment ◽  
Ponseti Method ◽  
Congenital Talipes Equinovarus ◽  
Talipes Equinovarus ◽  
Congenital Talipes ◽  
Good Differentiation ◽  
Recurrent Deformity

♦ Aetiology of idiopathic congenital talipes equinovarus remains unknown♦ Antenatal diagnosis is common with good differentiation of the idiopathic from the syndromic foot♦ The Ponseti method is the treatment of choice: results are poorer in the atypical and syndromic feet♦ Surgery is required in selected cases as the primary treatment and in others, as treatment for residual and/or recurrent deformity.

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