European Journal of Molecular & Clinical Medicine

Abstract

Aim: The aim of the study to analyze the efficacy and functional outcome between Ponseti and accelerated Ponseti in the management of CTEV.
Material and methods: This was an analytical study conducted in Department of Physical Medicine &Rehabilitation (PMR), Jawaharlal Nehru Medical College and Hospital, Bhagalpur, Bihar, India for the period of 2 years, after taking the approval of the protocol review committee and institutional ethics committee. A total of 100 children (120 feet) were treated. Among these 100 children, 50 children (60 feet) were treated by standard Ponseti method and 50 children (60 feet) were treated by accelerated Ponseti method.
Results: In the standard Ponseti group, 10 children had bilateral clubfoot, 20 were unilateral on left side, and 20 were unilateral on right side. Among 50 children, 33 (66%) were male and 17 (34%) were female. Mean age at presentation was 25.3 days. Total mean Pirani score at presentation was 4.89. Most of the cases required six casts for correction, with a mean of 5.66. Tenotomy was performed in six cases (12%). The mean number of days the child was in cast was 53.4. Eight cases (16%) had a relapse. All relapses were corrected by repeat casting. Mean Pirani score at 6 months follow-up was 0.081. In the accelerated Ponseti group, 10 children had bilateral clubfoot, 21 were unilateral on left side, and 19 were unilateral on right side. Among 50 children, 27 (54%) were male and 23(46%) were female. Mean age at presentation was 27.5 days. Total mean Pirani score at presentation was 5.036. The mean number of casts required for correction was 6.04. Tenotomy was performed in 11 cases (22%). The mean number of days the child was in cast was 40.12. 11 cases (22%) had a relapse, among which two case of equinus was treated with repeat tenotomy and others were corrected by repeat casting. Mean Pirani score at 6 months follow-up was 0.12.
Conclusion: we conclude that accelerated Ponseti method with plaster changes two times a week is as effective as Ponseti method in the treatment of idiopathic CTEV.