Outcomes of Ponseti technique in management of idiopathic clubfoot in Infants – A short term study of Ninety feet in rural India

Vol 35 | Issue 2 | May-Aug 2020 | page: 9-13 | Sunil Kumar¹, Prashant Pratap Singh¹, Mohit Kumar Singh¹, Yogesh Kumar¹, Satyendra Verma¹, Harish Kumar¹


Authors: Sunil Kumar¹, Prashant Pratap Singh¹, Mohit Kumar Singh¹, Yogesh Kumar¹, Satyendra Verma¹, Harish Kumar¹

¹Department of Orthopaedics, U P University of Medical Sciences Saifai, Etawah, UttarPradesh, India.

Address of Correspondence:
Dr. Harish Kumar,
U P University of Medical Sciences Saifai, Etawah, UttarPradesh, India.
E-mail: drharishkumar01@gmail.com


Abstract

Introduction: CTEV is one of most common deformity of foot and ankle, having incidence of 1 per 1000 childbirth. Male children are more commonly affected; male:female ratio 2:1 and bilateral foot involvements is in 50% of cases. It is accepted globally that first treatment for infants must be non operative irrespective of severity of deformity. The Ponseti method is the most popular and accepted worldwide for clubfoot, with excellent long-term outcome. The present study was carried out to analyse and the outcome of management of idiopathic clubfoot in infants using the Ponseti method in rural Indian population using pirani severity score.
Method: prospective interventional study was conducted from January 2017 to December 2018. Total no of patients included in study were 62 with 90 clubfeet. Infants with unilateral or bilateral clubfoot. Deformity was graded on Pirani severity score for hind foot, mid foot and total foot score. Manipulation and above knee casting were done as an OPD procedure and cases were followed for serial casting in the OPD weekly until desired correction was achieved. On each visit, observations were recorded on the Pirani severity score chart. In all patients, serial casting after manipulation was done according to ponseti technique as described. Percutaneous achilles tendon tenotomy was done if required. Final obseravtions were recorded when all deformities corrected and patient shifted to brace treatment from castings.
Results: The total Mean Pirani score at the time of presentation was 4.6 in 90 feet. At the time of final evaluation total mean Pirani score decreased to 0.55 ,that was statistically significant. At the final outcome, a total of 10 patients and 15 feet showed excellent results(pirani score: 0). 33 patients and 48 feet showed good results (score> 0 to 0.5). Only in 1 case presented a poor outcome (score >1). Fair results were observed in 11 patients and16 feet. Total 43 patients showed excellent to good results (78.18%) and poor results came in only 1 patient.
Conclusion: Ponseti technique, non invasive serial casting with per cutaneous tenotomy in management of idiopathic clubfoot inbinfants is highly successful, very cost effective with very less complications. In Indian rural areas it is very acceptable and satisfactory to patients
Keywords: Idiopathic clubfoot, Ponsati technique, Pirani score, Steenbeek brace


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How to Cite this Article: Kumar S, Singh PP, Singh MK, Kumar Y, Verma S, Kumar H | Outcomes of Ponseti technique in management of idiopathic clubfoot in Infants- A short term study of ninety feet in rural India | Journal of Bone and Joint Diseases| May-Aug 2020;35(2): 9-13.


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