EFFECTIVENESS OF ACCELERATED PONSETI THE TREATMENT OF CONGENITAL TALIPES EQUINOVARUS

Anwar Imran; Shujaat Ali; Sajid Akhtar; Lateef Khan; Baqir Hussain; Asad Ullah Jan

EFFECTIVENESS OF ACCELERATED PONSETI THE TREATMENT OF CONGENITAL TALIPES EQUINOVARUS

Anwar Imran, Shujaat Ali, Sajid Akhtar, Lateef Khan, Baqir Hussain, Asad Ullah Jan

Abstract

ABSTRACT

Objective: To assess the effectiveness of accelerated Ponseti Techniques (PST) in the treatment of congenital talipes equinovarus.

Methods: This descriptive study was conducted in the Orthopaedic Department, Jinnah Teaching Hospital Peshawar from July 2021 to January 2023. All the patients fulfilling the inclusion criteria were enrolled. The serial casting was given to all patients in the Outdoor Department. Outcome was assessed through the Pirani scoring system before and after casting. Statistical analysis was done using SPSS version 16. Frequencies and percentages were calculated for categorical variables. Mean± SD was calculated for numerical variables.

Results: The mean age of patients was 5.8± 2.4 months. Out of 52 patients, 32 (61.56%) were males and 20(38.46%) were female. Base line Pirani score was 6 and the mean follow up Pirani score of patients was 1.48 ± 1.01. Serial casting through accelerated technique (PST) was effective in 80.8%of patients. Patients treated with the accelerated Ponseti protocol achieved a mean Pirani score of 4.2, indicating significant improvement in foot deformity. Patients treated with the accelerated PST achieved initial correction in an average of 6.5 weeks.

Practical implication: This study demonstrated that Accelerated Ponseti is safe and effective for treatment of Congenital Talipes Equinovarus.

Conclusion: Our study concludes that Accelerated PST is safe, reliable and effective for treatment of Congenital Talipes Equinovarus. We recommend further studies with account taken into more variables which can determine the effectiveness accelerated PST before recommending accelerated PST for club foot.

Keywords

: Congenital Talipes Equinovarus, Pirani score, Ponseti technique, Safe Therapy, Technique.

Full Text:

PDF

References

Arif M,Inam M,Sattar A,Shabir M.Usefulness of PSTin management of congenital talipes equino-varus. JPak Orthop Assoc. 2011; 23:62-4.

Perry DC. The association between clubfoot and developmental dysplasia of the hip. JBoneJointSurg Br. 2010;92(11):1586-8

Gray K,Pacey V,Gibbons P,Little D,Burns J.Interventions for congenital talipes equinovarus (clubfoot).Cochrane Database Syst Rev 2014;8.Available at;http://online library.wiley.com/doi/10.1002/14651858.CD008602.pub3/abstract [Accessed July 31,2015]

Zionts LE, Sangiorgio SN, Ebramzadeh E, Morcuende JA. The current management of idiopathic club foot revisited: results of a survey of the POSNA membership J Pediatr Orthop.2012; 32(5):515–520.

Zhang W, Richards BS, Faulks ST, Karol LA, Rathjen KA, Browne RH. Initial severity rating of idiopathic club feet is an outcome predictor at age two years. J Pediatric Orthop B.2012; 21(1):16–19.

Shaheen S,Jaiballa H,Pirani S .Inter observer reliability in Pirani clubfoot severity scoring between a paediatric orthopaedic surgeon and a physiotherapy assistant.J PediatrOrthop B.2012;21(4):366–368.

Iltar S, Uysal M, Alemdaroğlu KB, Aydoğan NH, Kara T, Atlihan D. Treatment of clubfoot with the Ponseti method: should we begin casting in the newborn period or later? J Foot Ankle Surg. 2010; 49(5):426–431.

Zionts LE,Dietz FR.Bracing following correction of idiopathic clubfoot using the Ponseti method.J Am Acad Orthop Surg. 2010;18(8):486–493.

Morcuende JA,Abbasi D,Dolan LA,Ponseti IV.Results of an accelerated Ponseti protocol for club foot. J Pediatr Orthop. 2010; 25:623–626.

Harnett P,Freeman R,Harrison WJ,Brown LC,Beckles V.Anaccelerated Ponseti versus the standard Ponseti method: a prospective randomized controlled trial. J Bone Joint SurgBr.2011; 93(3):404–408.

Dobbs MB.Clubfoot:Etiology and Treatment.Clin Orthop Relat Res 2009;467:111.

MacNicolM.Themanagementofclubfoot:issuesfordebate.JBoneJointSurgery [Br] 2003; 85-B: 167-70.

Kampa R,Binks K ,Dunkley M,Coates C.Multidisciplinary management of clubfeet using the Ponseti method in a district general hospital setting J Child Orthop 2008;2:463–7.

Morcuende J, Abbasi D, Dolan L, Ponseti I. Results of an accelerated Ponseti protocol for clubfoot.J PediatrOrthop2005;25:623-6.

Ibraheem G, Adegbehingbe O,Bablola O, Agaja S, Ahmed B, Olawepo A et al(2007)Evaluation of an accelerated Ponseti protocol for the treatment of talipes eqvinovarus in Nigeria.East Cent Afr JSurg 22(1):28-38