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Midterm Results of Ponseti Management for Idiopathic Congenital Clubfoot at a Single Tertiary Center
Lulu Damsas1, Chethan B Shetty, Katapady Ramachandra Kamath
1Department of Orthopaedics, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India.
Background:
Congenital talipes equinovarus, also known as clubfoot, is one of the most common deformities of the musculoskeletal system in newborns. Although Kites developed one of the first nonsurgical methods, the Ponseti method is more popular, where counterpressure is applied on the talar head.
Methodology:
Two hundred and twelve idiopathic clubfeet were treated (84 bilateral and 44 unilateral) with the Ponseti method of casting; tenotomy was considered when the midfoot Pirani score was 0. Tenotomy was followed by casting for 3 weeks. The final functional outcome was assessed at 5 years (60 months) with Richard scoring.
Results:
The average number of casts applied for complete correction was 7.31, and 86.3% of the cases required tenotomy. Richard's scoring, one of the better midterm functional scores, obtained a good result in 94% of cases.
Conclusion:
Early intervention with the Ponseti method results in a plantigrade, functional foot that resembles a normal foot. This method is not only safe but also effectively reduces the economic and social burdens associated with clubfoot.
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