An accelerated Ponseti versus the standard Ponseti method: a prospective randomised controlled trial

Area of Science:

• Orthopedics
• Pediatric Orthopedics
• Medical Technology

Background:

• Idiopathic congenital talipes equinovarus (clubfoot) is a common birth defect.
• The standard Ponseti method involves weekly plaster casts for correction.
• Long treatment durations can pose challenges for families, especially those with long travel distances.

Purpose of the Study:

• To compare the effectiveness of an accelerated Ponseti method versus the standard method for treating clubfoot.
• To evaluate if reducing plaster change frequency impacts correction outcomes.
• To assess the impact of accelerated treatment on overall treatment duration.

Main Methods:

• Prospective randomized controlled trial comparing standard weekly plaster changes to an accelerated 3x/week schedule.
• Inclusion of 40 consecutive patients (61 feet) with idiopathic congenital talipes equinovarus.
• Pirani score used for initial and final assessment of deformity severity.

Main Results:

• No significant difference in final Pirani scores between the accelerated and standard groups (p = 0.308).
• Median treatment duration in plaster was significantly reduced in the accelerated group (16 days) compared to the standard group (42 days) (p < 0.001).
• Three patients in the accelerated group required extended treatment and were switched to the standard method.

Conclusions:

• The accelerated Ponseti method achieves comparable correction outcomes to the standard method.
• Accelerated treatment significantly shortens the duration of plaster immobilization.
• This approach offers a viable alternative, particularly beneficial for patients facing geographical or logistical challenges.