Shivakumar G.V1, Parvez Abraham Afzal2, Chaitanya P. R3
BACKGROUND
Globally neglected clubfoot is the most serious cause of physical disability among congenital musculoskeletal defects. 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 nations. We studied the effectiveness and functional outcome of idiopathic clubfoot treated with Ponseti technique of treatment.
MATERIALS AND METHODS
In our study, 64 male and 32 female patients were enrolled with bilateral involvement in 53 cases. We treated 149 idiopathic clubfeet in 96 patients using Ponseti technique of manipulation and serial casting followed by foot abduction brace.
RESULTS
The mean age at onset of treatment was 68 days (range 7-180 days). 87.8% (79 patients) presented to us in first 8 weeks after birth, average Pirani severity score was 5.46 points (range 4.5-6 points). Mean followup was 18 months (range 10-54 months). On average, 5.6 casts (range 4-10) were needed before performing the tenotomy. Tenotomy was carried out in 119 feet (85%), the mean postoperative Pirani score was 0.32 showing good/excellent results in 132 (94.3%) feet. Relapse was encountered in 10 patients (9%) and 16 clubfeet (11.4%).
CONCLUSION
Ponseti treatment method is economical and easy on the babies. If well implemented, it will greatly decrease the number of clubfoot cripples. It is particularly suited for developing countries where there are few orthopaedic surgeons per million populations.
