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Efficacy of Ponseti Manipualtion and Casting in Management of Idiopathic Clubfoot: Early Results
Keywords:
Clubfoot, Pirani scoring system, Ponseti method.Abstract
Objective: To evaluate the efficacy of Ponseti method for treatment of idiopathic clubfoot by correction of all deformities in terms of Pirani score ≤ 1 after completion of treatment.
Study Design: Prospective descriptive case series study.
Material and Methods: 55 patients of either gender from birth till two years of age were included. Children older than 2 years, those with secondary clubfeet and those who were operated upon before were excluded from study. Clubfeet were graded according to the Pirani scoring system and serial manipulations followed by weekly above-knee casting was done in the sequential order as described by Ponseti.
Results: The study was conducted for 15 months. Mean number of casts required was 5.25. Achilles tenotomy was required in 78.18% patients. Correction of deformities was achieved in 96.4% patients. Final Pirani score was documented to assess the success of treatment in terms of Pirani score ≤ 1. Patients were followed every week for casting and then every 6 weeks after completion of treatment for observation of maintenance of correction.
Conclusion: The Ponseti method is safe and effective treatment for congenital idiopathic clubfoot, and radically decreases the need for extensive corrective surgery.
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