Relapse of Clubfoot after Treatment with the Ponseti Method
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 6
Abstract
Background: During the last decade, Ponseti clubfoot treatment has become more effective and popular because of its high initial correction rate. But the problem affecting the long-term successful outcome is relapse of the deformity. The major problem is Non-compliance with Ponseti brace protocol associated with relapse. Although more comfortable braces have been reported to develop the compliance, they all have the same design and no significant changes have been made to the protocols. After refinement in the Ponseti method and emphasizing the significance of brace to parents, the relapse rate has been noticeably decreased. Objective: To evaluate relapse of Clubfoot after treatment with the Ponseti Method Methodology: A Cross sectional study including patients’ information during treatment period was done at outpatient basis in Prime Medical College, Rangpur, Bangladesh and the sample was 200 patients under Ponseti clubfoot treatment over a period of three years from 1 st October 2014 to 30th September 2017. The 200 patients with idiopathic legs with clubfoot 240 treated initially with the Ponseti technique who had relapse of their clubfoot were identified. Relapse was defined as a return to casting or surgery due to recurrent deformity. Data collected included demographics, treatment and brace adherence. Patients who sustained initial relapse before the age of two years were compared with those who sustained initial relapse after the age of two years. Results: After initial relapse prior to age two, bracing adherence does not affect likelihood of subsequent recurrence. Among the 200 patients with 240 legs with clubfoot after treatment with the Ponseti Method only 15 legs were relapse. Therefore from the study findings we can say that though there is some complications in Ponseti method but the treatment outcome is better than other methods. Conclusion: Patients with idiopathic clubfoot who experienced recurrence prior to age two years are significantly more likely to be non-adherent with bracing than those who sustain recurrence after age two.
Authors and Affiliations
Dr. Md. Shariful Haque, Dr. Mohammad Mushfiqur Rahman, Dr. Khaleda Perveen, Dr. Mahmuda Sharmin
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