Evaluation Of Patients With Congenital Idiopathic Clubfoot Treated By Ponseti Method: A Prospective Study
Journal Title: International Journal of Orthopaedics Traumatology & Surgical Sciences - Year 2017, Vol 3, Issue 1
Abstract
BACKGROUND Clubfoot occurs in approximately one in 1000 live births and is one of the most congenital birth defects. It is usually defined as a fixation of the foot in adduction, equines, cavus and varus. The Ponseti method is at present a well established method of treatment of idiopathic clubfoot deformities. The purpose of this study was to evaluate the results of serial casting with Ponseti method between 2014-2016 in orthopaedic clinics of Victoria hospital and Bowring and Lady Curzon hospital on the basis of Pirani’s Scoring and Radiological findings before and at the end of treatment. MATERIALS AND METHODS A total of 40 patients (53 feet) were enrolled in the study and were treated with Ponseti’s casting between November 2014 to June 2016 after grading the severity of deformity clinically by Pirani’s scoring and Radiologically by calculating the Talo- first metatarsal angle in AP view and Talo-Calcaneal angle in AP and stress dorsiflexion lateral views. Same clinical and radiological parameters were again assessed at the end of treatment before commencement of Foot abduction orthosis. RESULTS The average number of casts applied before full correction was 5.7. The duration of casts for more than 85% feet was less than 7 weeks. 90.5 % patients needed tenotomy for correction of equinus deformity. Pirani score significantly improved from an average of 5.7 on presentation to 0.5 after correction. Talo first metatarsal angle improved from an average of -53.8 degrees to 4.5 degrees and also Talo calcaneal angle improved from 0.4 to 21.4 degrees in AP view and from 3.7 to 29.2 degrees in lateral view CONCLUSION Ponseti’s method of manipulation and plaster corrects all 4 deformities associated with patients of congenital idiopathic clubfoot which is evident by statistically significant improvements clinically as measured by Pirani severity score and radiologically by Talo calcaneal and Talo first metatarsal angle and is associated with lower rates of complications.
Authors and Affiliations
Rachit Wadhwan, Hemanth HP
Keywords
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