International Journal of Research in Orthopaedics | March-April 2018 | Vol 4 | Issue 2 Page 238
International Journal of Research in Orthopaedics
Shinde GM et al. Int J Res Orthop. 2018 Mar;4(2):238-242
http://www.ijoro.org
Original Research Article
Evaluation of Ponseti method in correction of congenital talipes
equinovarus
Gopal M. Shinde
1
*, Yogesh A. Dhole
2
, Manoj R. Kashid
1
, Vijay R. Kakatkar
2
, S. K. Rai
3
INTRODUCTION
Congenital idiopathic clubfoot is a complex foot
deformity that occurs mostly in an otherwise normal
child. It is estimated that more than 1, 00,000 babies are
born worldwide each year with congenital clubfoot.
Eighty percent of the cases occur in developing countries.
Most are untreated or poorly treated. Neglected clubfoot
causes physical, social, psychological and financial
burden on the patients, their families and society as a
whole. Older methods of manipulations and serial casting
usually required many months of treatment and
frequently resulted in incomplete or defective correction.
1
As a result, extensive corrective surgery was indicated in
50% to 90% of the cases. Corrective surgeries are often
associated with disturbing failures and complications. In
addition, depending on the technique followed and the
residual deformity, up to 47% of the clubfeet undergo one
or more revision surgeries.
2,3
This has led to development
of renewed interest in non-operative management of
congenital talipes equino varus. Clubfoot in an otherwise
normal child 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.
ABSTRACT
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 scoring system. 7 (14.58%) patients had cast related
complications.
Conclusions: The Ponseti method is a safe, effective and reproducible method for correction of idiopathic congenital
talipes equinovarus which significantly reduces the rate of extensive corrective surgeries for correction of clubfoot.
Keywords: Congenital idiopathic clubfoot, Ponseti technique, Pirani scoring system
Department of Orthopaedics,
1
SMBT Institute of Medical Sciences and Research Centre, Nandi Hills, Dhamangaon,
Taluka-Igatpuri, Nashik, Maharashtra,
3
151 Base Hospital, Guwahati, Assam, India
2
Ramkrishna Medical Research Centre’s Jai Hospital Pvt Ltd, Tilakwadi, Sharanpur road, Nashik, Maharashtra, India
Received: 16 January 2018
Revised: 05 February 2018
Accepted: 06 February 2018
*Correspondence:
Dr. Gopal M. Shinde,
E-mail: drgopal@rediffmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20180460