ABSTRACT
@#Introduction: Idiopathic clubfoot or congenital talipes equinovarus (CTEV) is managed by the Ponseti method worldwide; however, the recurrence of the deformity is a challenging problem. The purpose was to review the factors associated with early recurrence of CTEV post the Ponseti method. Materials and Methods: During 2011-2016, 34 infants with 52 CTEV, who underwent the Ponseti method and a minimum follow-up period of six months, were reviewed. Twenty-two infants (65%) were male, and 18 infants (53%) had bilateral CTEV . Recurrence of CTEV was defined as ar eappearance of at least one of the four components of thed eformity. The association between recurrence and factors,i ncluding age, gender, bilaterality, family geography, type ofp rincipal caregiver, severity at presentation, centre where theP onseti method was initiated, compliance to foot abductionb race (FAB), practice of stretching exercise, type of FAB,a nd complications of casting, were evaluated usingu nivariate logistic regression analysis. R esults: The median age at initiation of the treatment was3 .4 (IQR; 2.1-12.6) weeks. A median of six (range; 3-12)c asts were required. Tenotomy was performed in 32/34( 94%) of cases. Recurrence occurred in 14/52 feet (27%) ata n average follow-up period of 2.3±1.1 years. Non-c ompliance to FAB protocol began at an average age of1 1.2±6.5 months, and significantly increased the risk ofr ecurrence during the weaning phase [OR (95%CI)=8.4 (1.2-9 2.4), p=0.03]. Other factors were not associated with ther ecurrence. Conclusion: Non-compliance to FAB occurred early during the treatment and related to a risk of recurrence of CTEV .P hysicians should encourage the parents and/or guardians tof ollow the protocol to decrease the risk of recurrence.