DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20180460

Evaluation of Ponseti method in correction of congenital talipes equinovarus

Gopal M. Shinde, Yogesh A. Dhole, Manoj R. Kashid, Vijay R. Kakatkar, S. K. Rai

Abstract


Background: Congenital idiopathic clubfoot is a complex foot deformity often requires many months of treatment and frequently resulted in incomplete or defective correction by older methods. Deformity can be corrected with serial manipulation and casting with minimal or no surgery as reported by Ponseti. This study is an attempt to evaluate the effectiveness of Ponseti technique in treatment of idiopathic congenital talipes equino varus.

Methods: 30 patients between age group of 01 to 24 weeks with 48 feet having congenital idiopathic clubfoot were treated using Ponseti technique. The guidelines for treatment were followed as per the Ponseti method of serial manipulation and casting at weekly intervals.

Results: 43 (89.58%) cases were treated successfully by using Ponseti technique without need of extensive surgery. 42 feet required tenotomy. 38 (79.16%) feet had an excellent outcome, 5 (10.42%) feet had a fair outcome and 05 feet (10.42%) had poor outcome as measured by the Pirani scoring system. 7 (14.58%) patients had cast related complications.

Conclusions: The Ponseti method is a safe, effective and reproducible method for correction of idiopathic congenital talipes equinovarus which significantly reduces the rate of extensive corrective surgeries for correction of clubfoot.


Keywords


Congenital idiopathic clubfoot, Ponseti technique, Pirani scoring system

Full Text:

PDF

References


Dimeglio A, Bonnet F, Mazeau PH, De Rosa V. Orthopaedic treatment and passive motion machine: consequences for the surgical treatment of clubfoot. J Pediatr Orthop B. 1996;5:173–80.

Bradish CF, Noor S. The Ilizarov method in the management of relapsed club feet. J Bone Joint Surg Br. 2000;82:387–91.

Krauspe R, Vispo Seara JL, Lohr JF. Long-term results after surgery for congenital clubfoot. Foot Ankle Surg. 1996;2:77–82.

Ponseti IV. Congenital clubfoot, Fundamentals of treatment, Oxford University Press, London, 1996.

Ponseti IV, Campos J. Observations on the pathogenesis and treatment of congenital clubfoot. Clin Orthop. 1972;84:50-60.

Turco VJ. Clubfoot, 1st edition, Churchill-Livingstone, New York, 1981.

Bohm M. The embryologic origin of clubfoot. J Bone Joint Surg. 1929;11:229-59.

Kite JH. The clubfoot, Grune and Stratton: New York; 1964.

Ponseti IV, Smoley EN. Congenital clubfoot- the results of treatment. J Bone Joint Surg. 1963;45:261-75.

Palmer RM. The genetics of TEV. J Bone Joint Surg. 1964;46:542.

Morcuende JA, Dolan LA, Frederick R, Dietz and Ponseti IV. Radical Reduction in the Rate of Extensive Corrective Surgery for Clubfoot Using the Ponseti Method. Paediatrics. 2004;113(2):376-80.

Herzenberg JE, Radler C, Bor N. Ponseti versus traditional methods of casting for idiopathic clubfoot. J Pediatr Orthop. 2002;22:517–21.

Goksan SB. Treatment of congenital clubfoot with Ponseti method. Acta orthop Traumato Turc. 2002;36(4):281-7.

Bhaskar A, Rasal S. Results of treatment of clubfoot by Ponseti’s technique in 40 cases: Pitfalls and problems in Indian scenario. Indian J Orthop. 2006;40:196-9.

Agarwal RA, Suresh MS, Agarwal R. Treatment of congenital clubfoot with Ponseti method. Indian J Orthop. 2005;39:244-7.

Changulani M, Garg NK, Rakagopal TS. treatment of idiopathic clubfoot using Ponseti method: initial experience. J Bone Joint Surg. 2006;88:1385-7.

Sterling Laaveg, Ponseti IV. Long term results of treatment of congenital clubfoot. Journal of Bone and Joint Surgery. 1980;62:23-31.

Colburn M, Williams M. Evaluation of the treatment of idiopathic clubfoot by using the Ponseti method. Journal of foot and ankle surgery. 2003;42:259-67.

Docker CE, Lewthwaite S, Kiely NT. Ponseti treatment in the management of clubfoot: a continuing role of paediatric orthopaedic services in secondary care centres. Ann R Coll Surg Engl. 2007;89:510-2.

Dyer PJ, Davis N. The role of Pirani scoring system in the management of clubfoot by Ponseti method. Journal of Bone and Joint Surgery. 2006;88:1082-4.

Shack N, Eastwood DM. Early results of physiotherapist delivered Ponseti service for the management of idiopathic congenital talipes equinovarus foot deformity. J Bone Joint Surg. 2006;88:1085-9.

Minkowitz B, Finkelstein BI, Bleicher M. Percutaneous tendo Achilles lengthening with a large gauge needle: a modification of the Ponseti technique for the correction of Idiopathic clubfoot. J Foot Ankle Surg. 2004;24(4):263-5.

Dobbs MB, Gordon JW, Walton T, Schoenecker PL. Bleeding complications regarding percutaneous tenotomy of tendo Achilles in the treatment of clubfoot deformity. J Paediatric Orthop. 2004;24(4):353-7.

Brewster MBS, Gupta M., Pattison GTR, Dunn-van der, Ploeg I.D. Ponseti casting – a new soft option. J Bone Joint Surg. 2008;90:1512-5.

Bor N, Herzenberg JE, Frick SL. Ponseti management of clubfoot in older infant. Clin Orthop. 2006;444:224-8.

Radler C, Suda R, Manner HM, Grill F. Early results of the Ponseti method for the treatment of idiopathic clubfoot. Z Orthop Ihre Grenzgeb. 2006;14:80-6.

Segev E, Keret D, Lokiec F. Early experience with the Ponseti method for the treatment of congenital idiopathic clubfoot. Isr Med Ass J. 2005;7:307-10.

Abdelgawad AA, Lehman WB, van Bosse SJ, Scher DM, Sala DA. Treatment of idiopathic clubfoot using the Ponseti method: minimum 2 year follow up. J Paediatric Orthop B. 2007;16:98-105.