DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20180683

Functional outcome of idiopathic congenital talipes equinovarus treated by Ponseti method: a midterm study

Madhuchandra P., Raju K. P., Pawankumar K. M., Shrinidhi I. S.

Abstract


Background: Idiopathic congenital talipes equinovarus is a characterized by deformities with lot of ambiguity regarding the forces maintaining the deformity and preventing its correction. The aim of our midterm study is to analyze the functional outcome of idiopathic congenital talipes equinovarus using Ponseti’s technique in Indian children presenting to us within the first three months of life without any prior treatment.

Methods: 87 patients with 132 feet were treated for correction of idiopathic congenital talipes equino varus using the Ponseti technique from September 2009 to January 2013 at our Institute. These patients were followed up in a prospective manner for a period ranging from twelve months to fifty seven months (mean period of follow up was thirty two months). Children were evaluated before casting and at the end of casting, then at monthly intervals for another two months. Further follow up was done every six weeks till three years of age and then at six monthly intervals.

Results: Our overall good to fair result was seen in 87.6% of cases. Rest of them had poor functional outcome. Long term follow up of all patients till skeletal maturity is required to know the final outcome of our treatment.

Conclusions: Severity of the deformity and the compliance of the parents and infants with orthotic devices for maintenance of the correction were the factors which ultimately determine the final outcome.


Keywords


Idiopathic congenital talipes equinovarus, Clubfoot, Ponseti’s technique

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References


Dobbs MB, Rudzki JR, Purcell DB, Walton T, Porter KR, Gurnett CA. Factors predictive of outcome after use of the Ponseti method for the treatment of idiopathic clubfeet. J Bone Joint Surg (Am). 2004;86(1):22-7.

Ponseti IV. Treatment of congenital clubfoot. J Bone Joint Surg Am. 1992;74(3):448-54.

Simons GW. Analytical radiography and the progressive approach in talipes equino varus Orthop Clin of North Am. 1978;9(1):187-206.

Ponseti IV. Idiopathic congenital talipes equino-varus. In: Ponseti IV, eds. Congenital Clubfoot Fundamentals of Treatment. 1st ed. New York: Oxford University Press Inc; 1996: 448-454.

Cummings RJ, Lovell WW. Operative treatment of congenital idiopathic club foot. J Bone Joint Surg Am. 1988;70(7):1108–12.

Harrold AJ, Walker CJ. Treatment and prognosis in congenital clubfoot. Bone Joint Surg Br. 1983;65(1):8-11.

Yamamoto H, Muneta T, Morita S. Non-surgical treatment of congenital clubfoot with manipulation cast and modified Denis-Browne Splint. Pediatr Orthop. 1998;18(4):538-42.

Cooper DM, Dietz FR. Treatment of idiopathic clubfoot. A thirty year follow-up note. J Bone Joint Surg. 1995;77(10):1477-89.

Barker S, Chesney D, Miedzybrodzka Z, Nicolla, Maffulli. Genetics & Epidemiology of Idiopathic Congenital Equino Varus. J Paediatric Orthop. 2003;23:265-72.

Noonan KJ, Richards BS. Nonsurgical management of Idiopathic clubfoot. J Am Acad Orthop Surg. 2003;11(6):392-402.

Herring A. Tachdjian's pediatric orthopaedics. 3rd edition. Philadelphia: WB Saunders; 2002.

Compenhout AV, Molenaers G, Moeus P, Fabry G. Does functional treatment of Idiopathic Clubfoot reduce the indication for surgery? A call for widely accepted rating system. J Paediatric Orthopaedics. 2001;10:315-8.

Fripp AT, Shaw NE. Clubfoot. London: E&S LivingstoneLtd; 1967.

Changulani M, Garg NK, Rajagopal TS, Bass A, Nayagam SN, Sampath J, et al. Treatment of idiopathic club foot using the Ponseti method-Initial Experience. J Bone Joint Surg Br. 2006;88(10):1385-7.

Laaveg SJ, Ponseti IV. Long-term results of treatment of congenital clubfoot. J Bone Joint Surg Am. 1980;62(1):23-31.

Frick SL. The Ponseti method of treatment for congenital Clubfoot: Importance of maximal forefoot supination in initial casting. Orthopaedics. 2005;2 (1):63-5.

Green ADL, Lloyd Roberts AG. The results of early posterior release in resistant Clubfeet: A long term review. J Bone Joint Surg. 1985;67:588-93.

Scher DM, Feldman DS, Van Bosse HJ, Sala DA, Lehman WB. Predicting the need for tenotomy in the Ponseti method for correction of clubfoot. J Paediatric Orthopaedics. 2004;24(4):349-52.

Doobs MB, Gordon JE, Walton T, Schoenecker PL. Bleeding complications following percutaneous tenotomy of Tendoachilles in the treatment of clubfoot deformity. J Paediatric Orthop. 2004;24(4):353-7.

Herzenberg JE, Radler C, Bor N. Ponseti versus traditional methods of casting for Idiopathic Clubfoot. J Paediatric Orthop. 2002;22:517-21.

Colburn M, Williams M. Evaluation of the treatment of Idiopathic clubfoot by using the Ponseti Method. J Foot Ankle Surg. 2003;42(5):259-67.