Influence of accelerated cast change interval in the Ponseti method: Study from rural and semi urban
Journal Title: Medpulse International Journal of Orthopedics - Year 2019, Vol 10, Issue 2
Abstract
Background:Ponseti method has proved to be an excellent outcome in the management of club foot. Ponseti method is a reliable and efficient way to manage club foot deformity when treatment is started early. Aims and Objectives: To evaluate the influence of the accelerated cast change interval on treatment outcomes by the Ponseti method. This case series is to spread awareness by showing the results of this technique used in semi urban centre. Materials and Methods: The case study was conducted at Bhaskar General Hospital, Yenkapally, Telangana from August 2017 to December 2018 and was followed up till April 2019. All the club feet patients reported to either Paediatric or Orthopaedic Outpatient and were taken for the study and the patients between birth and 12 months of age of either sex, were screened by Paediatrician for any associated problems and syndromes and only Idiopathic club feet were selected for the study. The selected 24 infants were treated between 07 days to 5months of age, out of which, 16 were male and 08 were female. Five male and one female infant had bilateral CTEV accounting to total of 30 feet. The majority of participants, nineteen infants (80%) were from rural Moinabad and five (20%) were from around semi urban Moinabad. General hygiene and maintenance was poor, which required frequent cast changes necessary in rural population. These cases were thus taken up for accelerated cast change study of Ponseti method. In the present case series, 24 cases of idiopathic clubfoot were treated by Ponseti method and assessed by Pirani scoring system. Cast was changed at an interval of 03 days for 4 to 5 weeks. The number of casts applied was, 09 to 11. Tendo Achilles tenotomy was done if required. The patients were followed uptoone yearof age from the removal of their last cast. Results: Correction was achieved in all the patients. Tendo Achilles tenotomy was performed in 83.3% of the patients. The Pirani score improvement was observed in all the 24 cases.Conclusion: Accelerated cast changes following the Ponseti technique did give good results as it was practised under supervision of well trained faculty and staff. It is good to spread the message of accelerated version of Ponseti method, that it can safely be used in the treatment of club foot correction.
Authors and Affiliations
B Sreekanth Rao, Cheeti Srinivas Kalyan Rao, G V S Moorthy
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