Accelerated Versus Standard Ponseti Method for Idiopathic Clubfoot: A Prospective Comparative Study of Correction and Outcomes

Background The standard Ponseti weekly manipulation and casting method is the gold standard for managing idiopathic clubfoot. The accelerated Ponseti biweekly manipulation and casting protocol, a promising innovation, has been proposed to significantly reduce treatment duration while maintaining efficacy. This study compared the outcomes of the accelerated and standard Ponseti techniques in terms of correction efficacy, treatment progression and the need for percutaneous Achilles tenotomy. Methods A prospective comparative study was conducted on 26 infants with 35 idiopathic clubfeet. Patients were allocated alternately into two groups based on their order of presentation to the clinic. The assignment was performed by the treating doctor in a strict alternating sequence. The accelerated Ponseti group (n = 17 feet) received biweekly manipulation and casting, and the standard Ponseti group (n = 18 feet) received weekly cast correction. The order of correction was the same in both groups. The Pirani score was used to determine severity and to monitor progress. The need for tenotomy was also documented. The results were analysed using appropriate statistical tests, providing a robust and comprehensive comparison of the two techniques. Results Baseline demographic characteristics did not differ significantly between the groups (p > 0.05). Both groups showed a progressive reduction in Pirani scores, with the accelerated group experiencing a faster decline. Tenotomy rates were comparable between the groups (p = 0.87). The accelerated Ponseti group required a significantly shorter casting duration (19.76 ± 6.9 days versus 35.39 ± 13 days; p < 0.001), indicating faster treatment completion without compromising correction. Conclusion The accelerated Ponseti method effectively corrects clubfoot deformities, yielding measured correction outcomes that did not significantly differ from the standard technique in this cohort. These findings indicate that the accelerated approach can significantly shorten treatment duration, providing a practical alternative for congenital talipes equinovarus (CTEV) management.