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[Early results of congenital clubfoot using Ponseti method]
Kryspin Ryszard Niedzielski1, Krzysztof Małecki, Małgorzata Kosińska
1Klinika Ortopedii i Traumatologii z Pododdziałem Chirurgii Reki dla Dzieci Instytutu Centrum Zdrowia Matki Polki w Łodzi.
Insights
The Ponseti method effectively treats congenital clubfoot in children, though results may vary. Consistent orthotic use is crucial for successful outcomes and avoiding surgery.
Area of Science:
- Orthopedics
- Pediatric Orthopedics
- Congenital Skeletal Defects
Context:
- Congenital clubfoot is a common birth defect with unclear causes.
- Non-surgical treatments are preferred for clubfoot management.
- The Ponseti method is a widely recognized non-surgical approach.
Purpose:
- To evaluate the early outcomes of congenital clubfoot treatment using the Ponseti method.
- To assess treatment success based on the need for surgical intervention.
- To analyze results within a one-year follow-up period.
Summary:
- This study analyzed 116 clubfeet in 92 children using the Ponseti method, with 82.7% achieving positive outcomes (avoiding surgery).
- A Dimeglio-Bensahel classification identified most cases as grade II or III clubfoot.
- Results showed a lower success rate than some literature, potentially due to early surgical referrals or compliance issues.
Impact:
- The Ponseti method is a viable, less invasive treatment for congenital clubfoot, often preventing extensive surgery.
- Emphasizes the critical role of consistent orthotic brace adherence for treatment success.
- Highlights the need for longer follow-up to fully ascertain long-term efficacy and potential complications.
Abstract:
Congenital clubfoot is one of the most common congenital skeletal defects. Its aetiology remains unclear. Due to its high incidence and social consequences, the therapy of congenital clubfoot presents an important medical issue. Non-surgical treatment methods are preferred. Many publications confirmed the efficacy of the Ponseti method. The aim of this study was to present early results of congenital clubfoot treatment using the Ponseti method in a one-year follow-up. The therapy protocol was in accordance with guidelines presented by the inventor. The necessity of surgical treatment was a criterion for negative treatment outcome. One hundred and sixteen feet of 92 children were analysed. A Dimeglio-Bensahel classification was used for the evaluation of the defect advance. Seventy-one feet (61.2%) were assessed as grade II, 43 feet as grade III (37.1%) and 2 feet as grade IV deformation. No patients with grade I deformation were included into the study. A positive treatment outcome was observed for 96 feet (82.7%), whereas a negative result for the remaining 20 feet (17.3%). Our results are therefore not consistent with the literature data. It could have resulted from the too precipitate qualification for surgery by the physician and problems with compliance. The Ponseti method is an effective and less straining treatment modality of the congenital clubfoot. In most cases it allows for avoiding extensive surgery and associated complications. A necessity of wearing an orthosis and a risk treatment failure, if not worn systematically, should be emphasised. A longer follow-up period is required for complete result analysis.
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