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Initiating Ponseti management in preterm infants with clubfoot at term age

Emily Scanlan1, Kate Grima-Farrell1, Emre IIhan1

  • 1Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, NSW, Australia.

Journal of Children'S Orthopaedics
|May 27, 2022
PubMed

Insights

Ponseti management for clubfoot in preterm infants treated at term age shows similar 1-year outcomes to those born at term. Further studies are needed to assess long-term results in this population.

Area of Science:

  • Pediatric Orthopedics
  • Neonatal Care
  • Congenital Abnormalities

Background:

  • Clubfoot is a common congenital foot deformity.
  • Optimal timing for initiating clubfoot treatment in preterm infants remains unclear.
  • The Ponseti method is a widely used conservative treatment for clubfoot.

Purpose of the Study:

  • To evaluate the 1-year treatment outcomes of the Ponseti method in preterm-born infants treated at term age.
  • To compare outcomes between preterm and term-born infants managed with the Ponseti method.

Main Methods:

  • Retrospective chart audit of preterm infants with clubfoot treated with the Ponseti method at term age (≥37 weeks gestation).
  • Data collected included gestational age at birth, age at treatment initiation, Pirani scores, number of casts, tenotomy rates, and recurrence rates.
  • Outcomes were analyzed up to 1 year post-correction.

Main Results:

  • Twenty-six preterm infants (40 feet) were included, with treatment initiated at a mean of 41.4 weeks gestation.
  • Idiopathic and syndromic clubfoot groups showed similar baseline Pirani scores and number of casts required for correction.
  • Achilles tenotomies were performed in 21% of idiopathic and 39% of syndromic cases; 1-year recurrence was observed in 5 feet.

Conclusions:

  • Ponseti management initiated at term age in preterm infants results in outcomes comparable to term-born infants at 1 year.
  • Long-term outcomes beyond 1 year require further investigation to assess alignment with growth and development.
Abstract

Keywords:
ClubfootCongenital Talipes EquinovarusPonsetiprematurityrecurrence

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