Risk Factors for Relapse and Surgical Intervention in Children with CTEV Treated by Ponseti Method

Area of Science:

• Orthopedics
• Pediatric Surgery
• Rehabilitation Medicine

Background:

• Congenital talipes equinovarus (CTEV) is a common birth defect.
• The Ponseti method is the standard treatment for CTEV.
• Relapses after the Ponseti method often necessitate further surgical intervention.

Purpose of the Study:

• To identify risk factors for relapse in children with CTEV treated using the Ponseti method.
• To evaluate the impact of treatment variables on relapse rates.
• To determine factors influencing the need for surgical intervention post-Ponseti treatment.

Main Methods:

• Retrospective study of 31 children (≤4 years) with CTEV treated between 2014-2023.
• Collected demographic and clinical data including Pirani score, casts, tenotomy, surgery, and bracing.
• Statistical analyses included descriptive statistics, univariate analyses, and logistic regression.

Main Results:

• Relapses occurred in 35.5% of cases, with 72.7% requiring recasting and surgery.
• Brace compliance was the only significant factor predicting relapse (p < 0.001).
• Compliant patients had a 90% lower odds of relapse compared to non-compliant patients.

Conclusions:

• Non-compliance with bracing significantly increases the risk of relapses and surgical intervention in CTEV.
• Close monitoring and strict adherence to bracing are essential for optimal outcomes.
• The Ponseti method's success is highly dependent on patient and caregiver compliance with post-treatment bracing.