Short term outcome of congenital clubfoot treated by Ponseti method

Abstract

Objective: To assess the effectiveness of the Ponseti technique in the treatment of congenital clubfoot in children in Ahvaz, Iran.

Methodology: The data of 42 patients (60 feet), who presented with clubfoot were treated with the Ponseti casting technique between October 2008 and November 2010 at Emam Khomeini Hospital, Ahvaz, south of Iran, were collected and studied retrospectively. The outcome was evaluated using the Pirani score for clubfoot. All the patients were followed up for 12 months.

Results: The mean age of patients was 3.7 days (ranged 1-24 days). The average time to achieve acceptable correction was 7.6 weeks (range: 6-10 weeks). Eight patients (10 feet) (16.7%) were not corrected with initial casting and required early surgery. Full correction was obtained in 34 patients (50 feet, 83.3%). Subcutaneous tenotomy of the Achilles tendon was performed in 36 feet (72%) and in 14 other feet it was not performed (28%). Tenotomy was performed more in children with higher Pirani score (P < 0.0001), and those with sever clubfoot had more chance for surgery (p < 0.0001).

Conclusions: The Ponseti casting technique is a safe and effective conservative treatment for clubfoot that decreases the need for surgical interventions. It is an easy method to be applied by most orthopaedic surgeons.