Abstract

Background: Closed treatment using Ponseti casting technique is the standard method of management for clubfoot deformity. The aim of this study was to investigate the efficacy of repeat use of Ponseti technique in late cases that had not achieved correction following previous attempts. Method: A prospective study was conducted on pa􀆟ents with clubfeet aged over 3 months who had not achieved correction with previous casting and were referred for surgery to our clinics. The baseline and final Pirani scores were compared in a 4.5- year average follow-up. The functional scores, recurrence rates, and additional procedures required for correction were also documented. Results: 79 feet in 53 pa􀆟ents aged from 3 months to 9 years were studied. They had mean Pirani scores of 4.4 and had previously received 7.8±2.5 cas􀆟ngs. Nine pa􀆟ents had Achilles tenotomy. A mean of 4.3±1.7 (range: 2–8) cas􀆟ngs and 32 Achilles tendon lengthening were needed to achieve complete correc􀆟on in 77 feet (98%). Relapse of deformity was seen in 42 (53%) feet, which led to 89% correc􀆟on rate in the final follow-up. However, the func􀆟onal score at the end , was good or excellent in 93% of the cases. Conclusion: Accurate re-use of Ponseti technique in cases of previously failed clubfoot casting has high success rate, even in late referrals. Level of Clinical Evidence : Level 4

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