Use of Ponseti's technique in recurrent clubfeet following Kite's method of correction
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Published on: January 24, 2018
K Durga Nagaraju1, S Vidyadhara, Ajoy P Shetty
1Department of Orthopaedics and Spine Surgery, Ganga Hospital, Ramnagar, Coimbatore, Tamil Nadu, India.
Insights
Ponseti
Area of Science:
- Pediatric Orthopedics
- Pediatric Orthopedics
- Pediatric Orthopedics
Background:
- Clubfoot is a common congenital foot deformity.
- Previous treatments, such as Kite's method, may result in recurrence.
- Recurrent clubfoot requires effective management strategies.
Purpose of the Study:
- To evaluate the effectiveness of the Ponseti technique for treating recurrent clubfeet.
- To assess the outcomes of Ponseti method in children previously treated with Kite's method.
Main Methods:
- Retrospective analysis of 18 recurrent clubfeet in 13 children.
- Treatment involved the Ponseti method, including casting and manipulation.
- Pirani scoring system used for pre- and post-treatment assessment.
Main Results:
- Successful correction of deformities in all patients, achieving plantigrade feet.
- Initial treatment reduced Pirani scores to zero.
- A 17% recurrence rate was observed at 6-month follow-up.
- Recurrences were managed with tenotomy or soft tissue release, yielding good results.
Conclusions:
- The Ponseti method is an effective treatment for recurrent clubfeet post-Kite's method.
- Short-term outcomes are promising, indicating the viability of this approach.
- Further long-term studies are recommended to validate these findings.
Abstract:
We report the results of 18 recurrent clubfeet in 13 children after Kite's method of casting treated successfully by Ponseti's technique. The average age was 8.3 months. The average preoperative Pirani's midfoot contracture score was 1.8, hindfoot contracture score was 2.4, and total score was 4.2. All patients had full correction of deformities with plantigrade feet and the scores were reduced to zero at the end of treatment. Three recurrences were found at 6 months follow-up, amounting to 17% failure rate. Two of them necessitated percutaneous tenotomy of the tendoachilles, and one underwent posteromedial soft tissue release with good result at the end of 1 year. Ponseti's method is an effective treatment option in the management of recurrent clubfeet after Kite's method. Although short-term results are promising, larger series with long-term follow-up is warranted.
