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Functional and clinical results achieved in congenital clubfoot patients treated by Ponseti's technique
Pedro Augusto Jaqueto1, Guilherme Salgado Martins1, Fernando Saddi Mennucci1
1Pontifícia Universidade Católica de Campinas (PUC-Campinas), Hospital e Maternidade Celso Pierro, Campinas, SP, Brazil.
Insights
The Ponseti method effectively treats congenital clubfoot, achieving a 90.2% success rate with significant clinical improvement. This technique offers a reliable approach for correcting this complex foot deformity.
Area of Science:
- Orthopedics
- Pediatric Orthopedics
- Surgical Techniques
Background:
- Congenital clubfoot is a common birth defect requiring effective treatment.
- The Ponseti method is a widely recognized non-surgical approach for clubfoot correction.
Purpose of the Study:
- To evaluate the functional and clinical outcomes of congenital clubfoot treated with the Ponseti technique.
- To assess the efficacy and success rate of the Ponseti method in a cohort of patients.
Main Methods:
- A retrospective study of 31 patients (51 feet) treated with the Ponseti technique.
- Included manipulation, casting, Achilles tenotomy for equinus, and anterior tibial tendon transfer for adduction.
- Pirani's classification was used for pre- and post-treatment evaluation.
Main Results:
- A 90.2% success rate was observed, with significant deformity improvement in 46 of 51 treated feet.
- The mean Pirani's score improved from 5.5 to 3.6 post-treatment.
- Male patients and right-sided, bilateral involvement were more common.
Conclusions:
- The Ponseti method demonstrated significant effectiveness in functional and clinical outcomes for congenital clubfoot.
- Achieved a high success rate (90.2%) and substantial improvement in the Pirani's index (65.5%).
- The technique proved reliable and statistically relevant for clubfoot management.
Objectives:
To analyze and evaluate functional and clinical results in patients with congenital clubfoot treated with Ponseti's technique.
Methods:
This study evaluated 31 patients diagnosed with 51 congenital clubfeet, treated between April 2006 and September 2011 with Ponseti's technique. The patients who did not achieve an equinus correction with manipulation were treated with Achilles tenotomy. An anterior tibial tendon transfer was performed in patients who maintained residual adduction. All plasters were made by fellows and supervised by Ankle and Foot Chiefs. The technique was performed without the need for physical therapists, orthotics, and plaster technicians. Patients were submitted to pre- and post-treatment examination and evaluated under Pirani's classification.
Results:
Male patients had an increased incidence and the right side was more affected, while bilateral involvement was observed in 64.5% of the cases. The mean number of cast changes was 5.8, and Achilles tenotomy was necessary in 26 patients. There were significant deformity improvements in 46 of the 51 treated feet (90.2%); Pirani's mean score improved from 5.5 to 3.6 after treatment.
Conclusion:
The Ponseti method was effective in both functional and clinical evaluation of patients, with significant statistical relevance (p = 0.0001), with a success rate of 90.2% and mean improvement in the Pirani's index of 65.5%.
