Management of idiopathic clubfoot by Ponseti’s method: a comparative clinical study on toddlers with radiological correlation

Authors

  • Rishabh Kumar 1Senior Resident, Department of Orthopaedics, Katihar Medical College, Katihar, Bihar-854105, India
  • Anshu Priya 2Junior Resident, Department of Radiodiagnosis, Katihar Medical College, Katihar, Bihar-854105, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20161862

Keywords:

Clubfoot, Idiopathic, Neglected, Ponseti

Abstract

Background: In developed countries, many children with clubfoot undergo extensive corrective surgery, often with disturbing failures and complications. The need for one or more revision surgeries is common. Although the foot looks better after surgery, it is stiff, weak, and often painful. Non-operative treatment of clubfoot provides a lower complication rate, less pain, and higher function as the patient ages. Lack of information regarding reasons for adherence to the regimen makes it difficult for health providers and health planners to determine the impact of treatments on health status or weigh the cost/benefit ratio for prescribing costly treatments to the patients. Therefore, it is important to understand how parents and health care givers manage their children’s treatment and the potential barriers these parents encounter during the utilization of clubfoot treatment services. It is important to determine the compliance of patients to clubfoot correction treatment in order to identify and target factors that may positively or negatively influence cases attending the clinic.

Methods: 25 cases with clubfoot were studied in the Department of Orthopaedics, Katihar Medical College. Out of these, 13 cases (Group A) were children over 1 year of age with neglected clubfoot and 12 cases (Group B) were children under one year of age with idiopathic clubfoot.

Results: The Ponseti method delivers excellent correction of clubfoot without the associated risks and complications of major foot surgery. Patients treated with Ponseti’s method have leverage in treatment of clubfoot than those treated by other conservative methods. The method provides more flexible foot and ankle than those treated surgically.

Conclusions: Treatment of clubfoot if commenced early will have better result. Children of age less than 1 year respond better than children of older age group. Younger children require fewer correction casts.

References

Laaveg SZ, Ponseti IV. Long term results of congenital clubfoot. J Bone Joint Surg. 1980;62:23-31.

Ponseti IV. Common error in the treatment of congenital clubfoot. Int Orthop. 1997;21:137-41.

Kite JH. Some suggestions on treatment of clubfoot by casts. J Bone Joint Surg Am. 1963;45:406-12.

Kite JH. Principles involved in the treatment of clubfoot. J Bone Joint Surg Am. 2003;85:1847.

Simons GW. Analytical radiography and the progressive approach in talipes equino varus Orthop Clin of North Am. 1977;59:485-9.

Attenborough CG. Severe congenital talipes equino varus. J Bone Joint Surg. 1948;13:16-9.

Turco VJ. Surgical correction of resistant clubfoot. One-stage posteromedial release with internal fixation: a preliminary report. J Bone Jt Surg Am. 1971;53:477-97.

Mackay DW. New concepts of and approach to clubfoot treatment section II correction of clubfoot. J Paed Ortho. 1983;3:10.

Simons GW. Complete subtalar release in clubfeet part-II comparison with less extensive procedures. J Bone Joint Surg 1985;1056-65.

Dobbs MB. J Bone Jt Surg Am. 2006;88:986-96.

Ippolito E. Long term comparatives results in patients with congenital clubfoot treated with two different protocols. J Bone Joint Surg Am. 2003;85:1286-94.

Ponseti IV. Editorial clubfoot management. J Paed Orthop 2000; 20:699-700.

Wynne-Davies R. Talipes equino varus. A review of eighty-four cases after completion of treatment. J Bone Jt Surg.1964;46:464.

Honein MA. Family history, maternal smoking, and clubfoot: an indication of a gene-environment interaction. Am J Epidemiol. 2000;152:658-65.

Tredwell SJ. Review of the effect of early amniocentesis on foot deformity in the neonate. J Paed Orthop. 2001;21:636-41.

Philip J. Late first-trimester invasive prenatal diagnosis: results of an international randomized trial. Obs-Gyn. 2004;103:1164-73.

Downloads

Published

2016-06-11

Issue

Section

Original Research Articles