Ponseti method: does age at the beginning of treatment make a difference?

Area of Science:

• Orthopedics
• Pediatric Orthopedics
• Podiatry

Background:

• The Ponseti method is a widely accepted treatment for idiopathic clubfoot.
• Previous studies suggest efficacy up to age 9, but the impact of treatment initiation age on outcomes remains unclear.

Purpose of the Study:

• To investigate whether the age at which children begin Ponseti method treatment influences successful correction rates and the likelihood of relapse.
• To compare outcomes in children treated before and after 6 months of age.

Main Methods:

• Retrospective review of 68 children (102 idiopathic clubfeet) treated with the Ponseti technique.
• Patients divided into two groups: younger than 6 months (Group I) and older than 6 months (Group II).
• Minimum follow-up of 30 months (mean 41.4 months).

Main Results:

• 100% initial correction rate in all feet, irrespective of age at treatment initiation.
• No significant differences between groups in the number of casts, tenotomies, or tibialis anterior transfers.
• Overall relapse rate was 8% in both younger and older children.
• The Ponseti method successfully avoided extensive surgery in 100% of cases across both age groups.

Conclusions:

• Age at the start of treatment does not appear to impact the success rate of the Ponseti method for idiopathic clubfoot.
• The Ponseti technique is highly effective in achieving initial correction and avoiding extensive surgery, regardless of patient age.
• Relapse rates are low and comparable between early and later treatment initiation groups.