CONGENITAL CLUBFOOT TREATED BY PONSETI TECHNIQUE

Abstract

Background: Clubfoot is a disease characterized by complex malformed feet or foot without the malformations of other bones and joints in the body. The objective of the study was to evaluate the conservative treatment of clubfoot in children by Ponseti technique of correction in our population.
Material & Methods: To evaluate conservative treatment by Ponseti technique in clubfoot, the study conducted was consecutive case series done in Orthopedics unit District Headquarter Hospital Dera Ismail Khan. Patients presented to OPD from October 2015 to September 2016 were included in this study. Children with clubfoot with no other congenital foot abnormalities and age less than 18 months were included. Children having clubfoot due to neuromuscular disease, arthrogryposis, mielodysplasia and postural clubfoot were excluded. Pirani scoring system was used in this study to see the effects of treatment before and after the procedure
Results; A total of 100 patients (146 feet) were treated. Follow up was done for a mean period of 24 months. Out of 100 patient’s male were 70 and female 30. Forty Six were bilateral and 54 unilateral. In our study we used the Pirani severity scoring system to compare our results. In our series the mean Pirani severity score before treatment was 5.05±1. The highest was 5.9 and the lowest being 1.9. At the end of serial cast and subsequent tenotomy, the mean Pirani severity score was 0.6±0.06, while range was 0.5 to 0.75 and the p value was 0.0001 which was highly significant.
Conclusion; Ponseti method of manipulation and plaster casting is very effective in correcting clubfoot deformity.