RESUMEN
Objective: To document the outcome of Ponseti method in the treatment of clubfoot
tudy Design: Observational-descriptive study
Place and Duration: Department of Orthopedic Surgery and Traumatology, Liaquat University of Medical and Health Sciences [LUMHS] Jamshoro, Sindh - Pakistan, from January 2007 to December 2010 [4-years]
Methodology: Clubfeet were treated by Ponseti technique. Pirani score was recorded for all subjects at the time of presentation and a foot was considered fully corrected when scored 0- 0.5. Immediately after the removal of last cast, foot abduction braces were used. Follow-up pattern was at two weeks, at three months, then at four month interval up to 3-years age, then at six month interval up to 4- years age, and then once a year. Any relapses were treated accordingly. Tenotomy was repeated in equines, whereas castings were repeated in adduction of forefoot, intoeing and cavus
Results: During the study period 49 children presented 71 clubfeet with 27 [55.1%] unilateral and 22 [44.9%] bilateral cases. The mean Pirani score at the time of presentation was 5.44. Majority [63.38%] feet required casting up to 5-weeks and in 69.01% feet complete correction was acquired by five casts [mean 5.6 casts]. Achilles tenotomy was performed in 65 [91.55%] feet. Pirani score of 0-0.5 was achieved in 69 [97.18%] cases within 1-year follow-up. Thirteen [18.31%] cases of relapse were reported. Among these, 2 [2.82%] cases of equinus underwent repeat tenotomy; whereas 7 [9.86%] cases of adduction, 3 [4.23%] cases of cavus and 1 [1.41%] case o intoeing were treated by repeat casting
Conclusion: Ponseti method can be used in our setup with excellent correction of clubfoot deformity, and surgical complications can be minimize by this technique