Comparison of Ponsetitechnique with Turco's posteromedial release in the management of congenital talipes equinovarus

ABSTRACT

To compare the results of Ponseti technique with one stage Turco's posteromedial release for correction of clubfoot in children of less than 12 month of age Comparative study Department of Orthopedics and Spine Surgery Postgraduate Medical Institute, Hayatabad Medical Complex Peshawar, from October 2008 September 2010. Patients were randomly selected by drawing lots, with even number included in group A [Ponseti Technique] and odd number in group B [Turco's posteromedial release]. Patients of either sex with age less one year having congenital talipes equinovarus were evaluated preoperatively by Pirani score, postoperatively by Mac Key score and were followed up for 2 years. Out of sixty patients, 23[38.3%] were males and 37 [61.7%] females. Fourteen [23.3%] patients had bilateral while 46 [76.7%] had unilateral deformity. Minimum age was 2 week, maximum 52 week and average 5.58 week. Using Pirani score preoperatively, there were 36[60%] patients with severe abnormality and 24[40%] feet were moderately abnormal. Using Mac Key score the functional results at last follow up in Group A were excellent in 16[26.7%], good in 13[21.7%] and failure noted in 1[1.7%] patient. At last follow up, functional results in Group B were excellent in 14[23.3%], good in 10[16.7%], fair in 4[6.7%] and poor in 1[1.7%] patient. Ponseti technique for an idiopathic clubfoot should be the choice for clubfeet. When there is recurrent deformity or resistant club foot then operative treatments may be considered