Ponseti method in treatment of idiopathic club foot

ABSTRACT

Clubfoot is a well known deformity that had a lot of attention; Dr. ponseti had proposed his own method of management with serial casting and minimal invasive surgeries that can be applied to a wider range of child age with less incidence of foot pain and stiffness compared to other methods of treatment, his technique is widely used after he published his paper in 1995. This study designed to prove that most of the children with congenital idiopathic club foot can be managed excellently by Ponseti method without the need for extensive corrective surgery. 53 children with 77 clubfeet were managed by serial manipulation and casting as described by Ponseti from May 2007 to July 2008 in Al-Wasity and Surgical specialty hospitals including initial correction of the deformity and minimal corrective surgery with follow up till October 2008. Total full correction was obtained in 91% of feet inrolled in this study, 71.6% of our patients were males, 28.3% were females, 45.2% with bilateral club feet, 54.7% with unilateral club foot, the number of casts required to full correction was 3-7 casts, 67.5% of our feet required percutaneous Achilles tenotomy to correct the equinus, 9% had incomplete correction [mainly equinus] which was corrected by open surgery, our complications was 5.1% with ulcer on the medial surface of head of 1[st] metatarsal, 7.7% with cast falling and 15.5% of feet developed relapse. The Ponseti method is a safe and effective treatment for congenital idiopathic clubfoot and radically decreases the need for extensive corrective surgery. This technique mostly useful in children up to 2 years of age, after that it can decrease the magnitude of any required procedure