Analysis of Ponseti Method in Congenital Talipes Equinovarus (CTEV)

ABSTRACT

Introduction: Congenital talipes equinovarus (CTEV) is the most common congenital foot disorder, commonly known as congenital clubfoot. Ponseti method of manipulation and serial plaster casting is the gold standard treatment for idiopathic congenital clubfoot. The purpose of this study is to analyse the efficacy of correction of Congenital Talipes Equinovarus deformity (CTEV) using ponseti method. Materials and Methods: This analysis was carried out at the Jhalawar Medical College Hospital's Orthopaedics Department, including 30 children with idiopathic CTEV of age less than 2 years, among which 13 unilateral and 17 bilateral CTEV, total 47 feet, willing for treatment. Patients were followed up weekly for corrective casting till tenotomy and corrective cast was applied for three weeks after final correction or percutaneous tendo-achilles tenotomy. Results: Assessment of results using Pirani severity scoring6,7 at the end of treatment and on regular follow-ups. The most common age group was 0-1 months with 24(80%) cases.Among 30 cases,there were 22 males(73.30%) & 8 females(26.70%). 17 cases were bilateral(56.67%) and 13 cases(43.33%) were unilateral. Post casting treatment, percutaneous tenotomy was done in 14 cases (46.67%) in which 12 cases(54%) were male and 2 cases(16%) were female. No patient has undergone extensive surgery like postero-medial soft tissue release or bony procedures to correct the deformity. Only two recurrence were recorded which was due to non compliance due to occurrence of pandemic COVID-19 Lockdown. They were treated with manipulation and pop cast followed D-B splint. Conclusion: Ponseti method is an excellent conservative method of treatment of Congenital Talipes Equino varus. Treatment must start at the earliest possible for better outcome. Long term follow up till 4 years age would be better to assess the relapse rate.