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Early developmental milestones in patients with idiopathic clubfoot treated by Ponseti method
Vito Pavone1, Marco Sapienza1, Andrea Vescio1
1Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, P.O. "Policlinico Gaspare Rodolico", University of Catania, Catania, Italy.
Insights
Congenital talipes equinovarus (CTEV) patients treated with the Ponseti technique achieve independent gait later than controls, but within developmental norms. Language development remains unaffected by this clubfoot treatment.
Area of Science:
- Pediatric Orthopedics
- Developmental Pediatrics
Background:
- Idiopathic clubfoot, or congenital talipes equinovarus (CTEV), is a common newborn lower limb deformity.
- Untreated CTEV can cause significant functional impairment.
Purpose of the Study:
- To assess developmental milestones in CTEV patients treated with the Ponseti technique compared to controls.
- To evaluate correlations between developmental milestones, deformity severity, and treatment intensity (number of casts).
Main Methods:
- Seventy-nine subjects (43 CTEV, 36 controls) were analyzed.
- Developmental milestones (babbles, independent gait, combined word) and clinical outcomes (Pirani Score, AOFAS, FADI) were recorded.
- Statistical analysis compared CTEV patients and controls, and assessed correlations within the CTEV group.
Main Results:
- Patients with CTEV achieved independent gait significantly later (16.8 months) than controls (13.2 months) (p=0.001).
- No significant differences were found in babbling or combined word attainment between groups.
- No correlations were identified between developmental milestones and deformity severity or number of casts.
Conclusions:
- Ponseti technique for CTEV results in delayed independent gait attainment, yet within normal developmental limits.
- Language development milestones are not impacted by Ponseti treatment for CTEV.
Background:
Idiopathic clubfoot, also referred to as congenital talipes equinovarus (CTEV), is one of the most common lower limb deformities observed in newborns, leading to significant functional impairment if untreated. The aims of this study were to (1) assess the developmental milestones in patients with CTEV treated by the Ponseti technique, and to compare them to the unaffected controls; (2) evaluate the possible correlation between developmental milestones, severity of the deformity, and number of casts.
Materials And Methods:
Seventy-nine subjects were divided into two groups, CTEV group (43 patients; 72 feet) and control group (36 patients). Age, sex, affected side, attainment of babbles (BAL), independent gait (IG), and combined word (CW) were recorded for all patients. In patients with CTEV, Pirani Score (PRS), number of casts (NC), and clinical outcome were collected according to the Clubfoot Assessment Protocol (CAP), The American Orthopedic Foot and Ankle Score (AOFAS), and Foot and Ankle Disability Index (FADI).
Results:
IG was achieved later later than the unaffected controls by 12/43 patients (27.9%) with CTEV and 3/36 patients in the control group (8.3%) (p = 0.04) and in a mean time of 16.8 ± 3.5 months and 13.2 ± 2.7 months, respectively (p = 0.001). In the CTEV group the mean value of CAP was 98.6 ± 4.7, of AOFAS of 98.4 ± 4.4 and of FADI equal to 99.9 ± 0.44. There were no statistically significant differences for BAL and CW; and no correlation with PRS, NC, or clinical score were identified.
Conclusion:
CTEV patients managed by the Ponseti technique achieve independent gait later than the unaffected controls, although they do so within the age limit of developmental. On the other hand, the Ponseti treatment has no impact on attainment of language development.
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