Outcome of Patients Suffering From Congenital Idiopathic Club Foot: A Comparative Analysis of Using Classical Versus Accelerated Ponseti Techniques

  • Jamil Ahmed Department of Orthopaedics, Ghurki Trust Teaching Hospital Lahore
  • Subhan Shahid Department of Orthopaedics, Ghurki Trust Teaching Hospital Lahore
  • Waqar Alam Department of Orthopaedics, Ghurki Trust Teaching Hospital Lahore
  • Ashfaq Ahmed Department of Orthopaedics, Ghurki Trust Teaching Hospital Lahore
  • Haseeb Hussain Department of Orthopaedics, Ghurki Trust Teaching Hospital Lahore
  • Rizwan Akram Department of Orthopaedics, Ghurki Trust Teaching Hospital Lahore
  • Amer Aziz Department of Orthopaedics, Ghurki Trust Teaching Hospital Lahore

Abstract

Objective: To compare the mean (days) required for correction of deformity by using classical versus accelerated Ponseti techniques in patients with congenital idiopathic clubfoot.


Methods: It was a Randomized controlled trial conducted in General Orthopaedic Ward Ghurki Trust Teaching Hospital affiliated with Lahore Medical & Dental College, Lahore. The Study was carried out over a period of six months from 25-07-2017 to 24-1-2019.The total number of patients were 80 (40 patients in each group) in this study. Group-A was treated with Standard Ponseti (SP) method and group-B was treated with accelerated Ponseti.


Results: Patients mean age was 1.6.±0.79 and 1.58±0.79 months in Group A and Group B, respectively. In Group A, 24 patients (60%) and in Group B 18 patients (45%) were males while 16 patients (40%) in Group A and 22 patients (55%) in Group B were females. Comparison of mean time (days) required for correction of deformity were 36.88±5.11 days and 20.73±3.40 in Group A and Group B respectively with p value <0.05.


Conclusion: The Accelerated form of Ponseti technique is a very effective way for managing patients with congenital club foot.It reduces the duration of total casting without any effect on outcome as compared to classical method of ponseti.

References

Equinovarus foot malformations. European Journal of Medical Genetics 2014;57(8):473-9.
2. Tembhurnikar R,Dulani R,Rawate S,Kothari P.Management of club foot:Our experience.Global Journalof Research Analysis 2018;7(5):45-52.
3. Shylaja D,Menasinkai SB,Ramesh B.Study of Congenital Clubfoot in Newborns.Int J Anat Res 2016;4(4):3072-78.
4. Rasit A,Azani H,Zabidah P,Merikan A, Nur Alyana B.Clubfoot:The management outcome using quantitative assessment of deformity.Malaysian Orthopaedic Journal 2012;6(S):2-5.
5. Hallaj-Moghaddam M,Moradi A,Ebrahimzadeh MH,Habibzadeh Shojaie SR.Ponesti Casting for sever clubfoot deformity:Are clinical Outcomes Promising?Advances in Orthopaedics 2015;13-19.
6. Rijal R,Shrestha BP,Singh GK,Singh M,Nepal P,Khanal GP et al.Comparision of Ponesti and Kite’s method of treatment for idiopathic clubfoot.Indian Journal of orthopaedics 2010;44(2):202-7.
7. Solanki M,Ajmera A,Rawat S.Comparative study of accelerated Ponseti method versus Standard Ponseti Method for the treatment of idiopathic clubfoot.Journal of Orthopaedics Traumatology and Rehabilitation 2018;10(2):116-9.
8. Chesney D,Barker S,Maffulli N.Subjective and objective outcome in congenital clubfoot:A comparative study of 204 children 2007;53-59.
9. Mejabi J,Esan O,Oladirn Adegbehinbe O,Asuquo J,Akinyoola A.A prospective Cohort study on Comparision of early outcome of classical Ponseti and Modified Ponseti post tenotomy in clubfoot management.Annals of Medicine and Surgery 2017;24:34-37.
10. Abd El-Latief,Yassin I,Algushily A,Khamis A.Treatment of Congenital Idiopathic Talipes Equinovarus with Ponseti Method.The Egyptian Orthopaedic Journal 2013;48(2):131-5.
11. Dobbs MB,Gurnett CA.Update on Clubfoot:Aetiology and treatment.Clinical Orthopaedics and Related Research 2009;46(5):1146-48.
12. Ponseti IV,Zhivkov M,Davis N,Sinclair M,Dobbs MB,Morcuende JA.Treatment of the complex Idiopathic Clubfoot.Clinical Orthopaedics and related Research 2006;451:171-6.
13. Harnett P,Freeman R,Harrison W, Brown L,Beckles V.An accelerated Ponseti Versus the Standard Ponseti method:A prospective Randomised Controlled Trial.J Bone Joint Surg(Br) 2011;93(3):404-8.
14. IbraheemG, Adegbehingbe O,Babalola O,Agaja S,Ahmed B,Olawepo A, et al.Evaluation of an Accelerated Ponseti Protocol for the treatment of Talipes Equinovarus in Nigeria.East and Central African Journal of Surgery 2017;22(1):28-38.
15. Ullah S,Inam M,Arif M.Clubfoot management by accelerated Ponseti Technique.Rawal Medical Journal 2014;39(4):51-55.
16. Morcuende JA,Abbasi D,Dolan LA,Ponseti IV.Results of an Accelerated Ponseti Protocol for clubfoot.Journal of Pediatric Orthopaedics 2005;25(5):623-6.
17. Pirani S,Naddumba E,Mathias R,Konde-Lule J,Penny JN,Beyeza T, et al.Towards effective Ponseti Clubfoot Care:The Uganda sustainable clubfoot care project.Clinical Orthopaedics And Related Research 2009;467(5):1154-63.
18. Evans Am,Van Thanh D. A Review of the Ponseti method and development of an infant clubfoot program in Vietnam.Journal of the American Pediatric Medical Association 2009;99(4):306-16.
Published
2019-09-30
How to Cite
AHMED, Jamil et al. Outcome of Patients Suffering From Congenital Idiopathic Club Foot: A Comparative Analysis of Using Classical Versus Accelerated Ponseti Techniques. Journal of Pakistan Orthopaedic Association, [S.l.], v. 31, n. 02, p. 44-47, sep. 2019. ISSN 2076-8966. Available at: <http://jpoa.org.pk/index.php/upload/article/view/309>. Date accessed: 17 nov. 2019.

Most read articles by the same author(s)

Obs.: This plugin requires at least one statistics/report plugin to be enabled. If your statistics plugins provide more than one metric then please also select a main metric on the admin's site settings page and/or on the journal manager's settings pages.