Ponseti Technique for the Management of Congenital Talipes Equinovarus in a Rural Set-Up in India: Experience of 356 Patients (original) (raw)
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International Journal of Research in Orthopaedics, 2018
Background: Congenital clubfoot also known as CTEV (congenital talipus equinovarus) is a common and debilitating congenital musculoskeletal anamoly affecting the children across the world with a slight preponderence in third world countries. The Ponseti technique of casting has now become the mainstay of treatment of this condition. This method is especially effective in rural and underdeveloped areas with limited health care facilities. The purpose of this study was to evaluate the effectiveness of the Ponsetti technique in the correction of this deformity, thorough the assessment of modified Pirani score. Methods: This was a prospective observational study conducted on 75 patients of either sex with 100 feet, with an average age of 3.6 months presenting to the
Outcomes of Congenital Talipes Equinovarus Treated with Ponseti Method
International Journal of Contemporary Medical Research [IJCMR], 2019
Idiopathic clubfoot or congenital talipes equinovarus is characterized by an excessively turned-in foot and a high medial longitudinal arch is the commonest congenital foot deformities having 1 in every 1000 children born worldwide. Though described long back, there has been an interest towards Ponseti method of conservative treatment of clubfoot recently. Our study was aimed to assess the efficacy of Ponseti technique in correcting congenital talipes equinovarus deformity of foot. Material and methods: 65 patients were enrolled in the study out of which 47 patients were available for final follow-up. All patients presenting with CTEV with age up to 2 years were included and patients more than 2 years, operated cases and syndromic clubfoot were excluded. We treated all patients with Ponseti method of serial casting and tenotomy. results: Out of the total 65 feet studied, 42 feet (64.62%) required tendo achilles tenotomy and 23 feet (35.38%) were treated with casting alone and tenotomy was not required. In our study, there were 8 cases of relapes (12.31%).Out of these, 7 were idiopathic and 1 was syndromic. Out of these 8 relapses, 2 required repeat tenotomy and 6 were treated with casting as per ponseti technique. Complications due to plaster were minimal in our study. Incidence of rocker bottom feet in our study is nil because of dedicated clubfoot manipulation in clubfoot clinic and patients were followed up regularly. Conclusion: To conclude, this study showed that clubfoot deformity can be managed successfully provided the technique and details of manipulation described by Ponseti are followed strictly and patients can be followed up regularly by a team of dedicated orthopedic surgeons.
Asian Journal of Pharmaceutical and Clinical Research, 2018
Objective: The earliest non-surgical treatment for the correction of congenital idiopathic talipes equinovarus (CTEV) deformity was described by Ignacio Ponseti. He suggested gentle manipulation and serial applications of casts followed by a period of bracing to maintain the correction. The main objective of this study was to evaluate the result of the Ponseti method with a subjective clinical scoring system using Pirani score, to compare the results with the published literature and to evaluate the effectiveness of foot abduction orthosis (FAO) or ankle-foot orthoses (AFO) in preventing relapse following correction.Methods: A cross-sectional study which was conducted at the Paediatric Orthopaedic Clinic, Universiti Kebangsaan Malaysia Medical Centre (UKMMC). A minimum of 12 months follow-up casting was observed before the patient was subjected to the subjective clinical scoring system. A total of 25 patients which included 5 right feet, 9 left feet, and 10 bilateral feet with idio...
Evaluation and outcome of ponseti method in the form of treatment of congenital idiopathic clubfoot
Talipes equinovarus or clubfoot, in the definition is a congenital deformity concludes of cavus, forefoot adduction, heel varus, ankle equinus and internal tibial torsion. The overall demographic prevalence of clubfoot was 1.30 per 1000 live births; 1.37 among non-Hispanic whites, 1.30 among Hispanics, and 1.14 among non-Hispanic blacks or African Americans. Unilateral clubfoot is somewhat more common than bilateral clubfoot and may occur as an isolated defect or in association with other disorders (eg, chromosomal aberrations, cerebral palsy, spina bifida, arthrogryposis). Our study aim was to evaluate Ponseti Method in the form of treatment of congenital idiopathic clubfoot. This was a quasi-experimental study was conducted in the department of Orthopaedic Surgery in Rajshahi Medical College Hospital, Rajshahi, Bangladesh during the period from January 2018 to December 2019. Data were collected non prospectively in randomized pattern from patients with idiopathic clubfoot, presenting in this hospital. Both, unilateral, bilateral were included in the study. In this study, we have treated 47 children with idiopathic clubfoot by Ponseti Method of correction of serial manipulation and casting. Among the 47 children, 24 had unilateral and 23 bilateral involvement. Male were 27 and remaining 20 were female. Most children had grade III and grade IV (Dimeglio et al grading) deformity. The mean number of casts required was 5.67 (4 to 10). Tenotomy was required for 18 patients (38.29%). The scores for the entire group ranged from 4.0 to 7.0 (of 19) and 4 to 19 (of 28) in the Dimeglio classification. Pirani scores for the age group 0-6 months were 4.45, 6 months to 1 year were 5.29 and 1-2 years were 5.65 respectively. The results were excellent in 37 (79 %), good in 7 (14 %) and inefficient in 3 (6 %). Initial and final scores were statistically evaluated with paired " T" test with a " T" value of 37.13 with a " P" value of less than 0.001. Thus there was a significant reduction in the score from the pre level because of intervention. Results: Similar good results and low requirement for surgical interventions other than Achilles tenotomy, which forms part of the Ponseti regimen, were found. In terms of number of patients, the success rate is 93.6% and in terms of the number of feet the success rate is 93.6%. This study demonstrates that treatment of congenital talipes equine varus by conservative management of Ponseti Method can considered as one of the most common and effective treatment method.
Journal of Research in Orthopedic Science, 2022
Background: Congenital talipes equinovarus (CTEV) is a prevalent congenital foot deformity. The Ponseti method is a non-surgical treatment for clubfoot, which entails a sequence of casts and braces. The accelerated Ponseti method is a modified version of the standard Ponseti method, involving more frequent cast changes. Methods: A total of 60 patients with idiopathic congenital talipes equinovarus (CTEV) under the age of one were carefully chosen and assigned to two groups of A (standard) and B (accelerated). The Pirani score was used to evaluate each clubfoot before applying a cast. In group A, aboveknee casting was performed once a week, while in group B, it was done twice a week. Results: The study involved 60 children with a total of 75 feet. The results indicated a shorter treatment duration with the accelerated Ponseti method, while the occurrence of skin complications was comparable between the two methods. Conclusion: In conclusion, both the accelerated and standard Ponseti methods are equally effective in correcting clubfoot. The accelerated method offers the advantage of reducing the overall treatment duration and has clear benefits, while no notable difference is observed in skin complications between the two methods.
Idiopathic clubfoot is a complex deformity and is difficult to treat. The goal of the treatment is to reduce or eliminate all components of the deformity so that the patient has a pain free, plantigrade, mobile foot with good function and without callosities. We have treated 31 patients with 45 clubfeet using ponseti technique. Grading system of Dimeglio et al was used to assess the severity of deformity. The average number of costs applied for obtaining correction was 6, ranging from 4 to 9. Tenotomy was done in 40 feet. 40 feet had good results; 3 patients (5 feet) developed recurrence because of non-compliance of use of orthosis.
"An Evaluation of Ponseti Method for the Treatment of Congenital Idiopathic Clubfoot."
IOSR Journals , 2019
Clubfoot, or talipes equinovarus, is a congenital deformity consisting of cavus, forefoot adduction, heel varus, ankle equinus and internal tibial torsion. The overall prevalence of clubfoot was 1.29 per 1000 livebirths; 1.38 among non-Hispanic whites, 1.30 among Hispanics, and 1.14 among non-Hispanic blacks or African Americans. 1 Unilateral clubfoot is somewhat more common than bilateral clubfoot and may occur as an isolated defect or in association with other disorders (eg, chromosomal aberrations, cerebral palsy, spina bifida, arthrogryposis). Our study aim was to evaluate Ponseti Method for the treatment of congenital idiopathic clubfoot. This was a descriptive cross-sectional study conducted in the dept. of Orthopaedics, Jashore Medical College Hospital during the period from January 2017 to June 2018. Data was collected from patients with idiopathic clubfoot, presenting at selected hospital. Both, unilateral, bilateral were included in the study. In this study, we have treated 46 children with idiopathic clubfoot by Ponseti Method of correction of serial manipulation and casting. Among the 46 children, 24 had unilateral and 22 bilateral involvement. Male were 26 and remaining 20 were female. Most children had grade III and grade IV (Dimeglio et al grading) deformity. The mean number of casts required was 5.66 (4 to 10). Tenotomy was required for 17 patients (37%). The scores for the entire group ranged from 4.0 to 7.0 (of 18) and 4 to 19 (of 28) in the Dimeglio classification. Pirani scores for the age group 0-6 months were 4.44, 6 months to 1 year were 5.28 and 1-2 years were 5.64 respectively. The results were excellent in 36 (82%), good in 7 (15%) and inefficient in 3 (6.52%). Initial and final scores were statistically evaluated with paired "T" test with a "T" value of 37.13 with a "P" value of less than 0.001. Thus there was a significant reduction in the score from the pre level because of intervention. Results: Similar good results and low requirement for surgical interventions other than Achilles tenotomy, which forms part of the Ponseti regimen, were found. In terms of number of patients the success rate is 93.5% and in terms of the number of feet the success rate is 94%. This study demonstrates that treatment of congenital talipes equine varus by conservative management of Ponseti Method can considered as one of the most effective treatment method.
Evaluation of Ponseti method in correction of congenital talipes equinovarus
International Journal of Research in Orthopaedics, 2018
Background: Congenital idiopathic clubfoot is a complex foot deformity often requires many months of treatment and frequently resulted in incomplete or defective correction by older methods. Deformity can be corrected with serial manipulation and casting with minimal or no surgery as reported by Ponseti. This study is an attempt to evaluate the effectiveness of Ponseti technique in treatment of idiopathic congenital talipes equino varus.Methods: 30 patients between age group of 01 to 24 weeks with 48 feet having congenital idiopathic clubfoot were treated using Ponseti technique. The guidelines for treatment were followed as per the Ponseti method of serial manipulation and casting at weekly intervals.Results: 43 (89.58%) cases were treated successfully by using Ponseti technique without need of extensive surgery. 42 feet required tenotomy. 38 (79.16%) feet had an excellent outcome, 5 (10.42%) feet had a fair outcome and 05 feet (10.42%) had poor outcome as measured by the Pirani sc...
Ponseti Method in the Management of Clubfoot under the 4 Years of Age
Pakistan Journal of Medical and Health Sciences
Background: The number of children born in the United States with a congenital clubfoot rises steadily each year. As per the Centers for Disease Control and Prevention, CTEV is spread once every 1,000 births. The vast majority of those infants are born in countries where they are mistreated or get insufficient care, resulting in a decrease in their overall life quality. CTEV has managed and been familiar to humanity since the dawn of time, and its surrounding disputes have existed similarly. Numerous studies have contributed to our understanding of patho-anatomy and therapy accountability for various illnesses. This study looked at how well a CTEV cast repair worked after a series of Ponseti cast repairs. Objective: Patients with a history of congenital talipesequinovarus who underwent serial cast repair using the Ponseti procedure were the focus of the study. Study Setting: Teaching Hospital Kech ;Turbat Pakistan Methods: The Ponseti method was used to treat 60 children between Jun...