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Ponseti's vs. Kite's method in the treatment of clubfoot--a prospective randomised study
Alok Sud1, Akshay Tiwari, Deep Sharma
1Orthopaedics, Lady Hardinge Medical College, U-V/ 116 C, Block B, Shalimar Bagh, New Delhi 110088, India. avimukta2@gmail.com
Insights
Ponseti
Area of Science:
- Orthopedics
- Pediatric Orthopedics
- Pediatric Surgery
Background:
- Idiopathic congenital clubfoot is a common birth defect.
- Conservative management aims to correct the deformity without surgery.
- Ponseti and Kite methods are established conservative treatments.
Purpose of the Study:
- To compare the efficacy of Ponseti's method versus Kite's method for idiopathic congenital clubfoot.
- To evaluate correction rates, relapse rates, and time to correction.
Main Methods:
- Prospective randomized study of 45 infants (67 feet) under 3 months old.
- Comparison of Ponseti's method (36 feet) and Kite's method (31 feet).
- Average follow-up of 27.24 months (Ponseti) and 24.8 months (Kite).
Main Results:
- Ponseti method achieved 91.7% correction with minimal surgery; Kite method achieved 67.7% correction requiring more surgery.
- Ponseti group had fewer relapses (21.1%) and faster correction with fewer casts.
- Ponseti's method showed superior results, especially for severe clubfoot cases (Dimeglio classification).
Conclusions:
- Ponseti's method is superior to Kite's method for treating idiopathic clubfoot in infants.
- Ponseti's method offers higher correction rates, shorter treatment times, and fewer casts.
- Early intervention with Ponseti's method is recommended for idiopathic clubfoot management.
Abstract:
Ponseti's and Kite's methods of conservative management in idiopathic congenital clubfoot were compared in a prospective randomised study consisting of 45 infants (67 feet) younger than 3 months, from March 2003 through February 2004. There were 36 and 31 feet that underwent treatment by Ponseti's and Kite's methods, respectively. After an average follow-up of 27.24 months in the Ponseti group, correction was achieved in 33 feet (91.7%), with only three patients requiring surgical management. There were seven relapses (21.1%), all of which were corrected conservatively. However, two of these required surgical intervention on showing a relapse again in the second year. In the Kite group, we achieved correction in 21 feet (67.7%) after an average follow-up of 24.8 months, with ten patients requiring surgical intervention. There were eight relapses of which only four could be corrected conservatively. We could also achieve correction in very severe feet (Dimeglio classification) in a significantly higher percentage using Ponseti's method, in significantly lesser time and with fewer casts. We are of the opinion that Ponseti's method is superior to Kite's method in achieving correction in idiopathic clubfeet in a relatively shorter period of time when used to treat young infants.