Results of a Standard versus an Accelerated Ponseti Protocol for Clubfoot: A Prospective Randomized Study

BACKGROUND@#The aim of this study was to compare the results of the standard once-weekly Ponseti casting technique to an accelerated twice-weekly regimen in our population cohort.@*METHODS@#A prospective randomized controlled study was conducted with a total of 100 consecutive patients (158 feet) being enrolled for the study. Fifty patients were randomized to each group and followed up for at least one year.@*RESULTS@#Initial mean Pirani score was 4.67 ± 0.73 in the standard group and 4.35 ± 0.76 in the accelerated group, and the score decreased to 0.34 ± 0.38 and 0.35 ± 0.31, respectively. Initial mean Dimeglio score was 11.75 ± 2.75 in the standard group and 10.51 ± 2.57 in the accelerated group, and the score decreased to 0.79 ± 0.77 and 0.79 ± 0.71, respectively, immediately after casting. The average number of casts required to correct all the deformities was 6.3 ± 1.2 in the standard group and 6.1 ± 1.4 in the accelerated group (p = 0.45). Average time spent in cast was 58.2 ± 8.3 days in the standard group and 39.5 ± 5.2 days in the accelerated group (p < 0.001). Percutaneous Achilles tendon tenotomy was done in 86.42% in the standard group and in 84.41% in the accelerated group (p = 0.72). Final results were assessed by using a modified functional rating scoring system: 55.55% clubfeet had excellent results and 44.45% had good results in the standard group, whereas 66.23% clubfeet had excellent results and 33.77% had good results in the accelerated group. None amongst the two groups had fair or poor results.@*CONCLUSIONS@#These results suggest that the accelerated Ponseti technique significantly reduces the correction time without affecting the final results and that it is as safe and effective as the traditional Ponseti technique.

Subungeal glomus tumor - a case report

Glomus tumor is a rare benign neoplasm that arises from the neuroarterial structure called a glomus body and accounts for 1% to 2% of soft tissue tumors in the hand. We present a case of a 36-year-old female who was treated for subungal glomus tumour of thumb

Bilateral Petit’s Triangle Hernia

Lumbar traingle hernia that occurs through lumbar triangles is very rare type of hernia. Only about 300 cases have been reported till date. Bilateral Petit’s triangle hernia find further rarity and the case under reference is probably the first ever reported case of Primary bilateral Petit’s triangle hernia. The present case is of a 46 years old married, multigravida female who presented with 1 year duration of LBA and subsequently notice of swelling both sides of low back. FNAC revealed lipoma and on exploration it turned out to be rarest extra peritoneal bilateral Petit’s triangle hernia, fat as contents.