Online ISSN: 2515-8260

Conventional Ponseti vs. Accelerated Ponseti in the management of cases of idiopathic Clubfoot

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Dr. Rakesh Kumar1 , Dr. Sushil Kumar Singh

Abstract

Aim: The aim of the study to analyze the efficacy of accelerated Ponseti method in the management of CTEV. Material and methods: This was a prospective observational study conducted in the Department of Orthopaedics, Vardhman Institute of Medical Sciences, Pawapuri, Nalanda Bihar, India from March 2016 to February 2017, after taking the approval of the protocol review committee and institutional ethics committee. A total of 70 children (100 feet) were treated. Among these 70 children, 35 children (50 feet) were treated by standard Ponseti method and 35 children (50 feet) were treated by accelerated Ponseti method. Results: A total of 70 children (100 feet) were treated; of which 35 children (50 feet) were treated by standard Ponseti method and 35 children (50 feet) were treated by accelerated Ponseti method. In the standard Ponseti group, 15 children had bilateral clubfoot, 10 were unilateral on left side, and 10 were unilateral on right side. Among 35 children, 22 (62.86%) were male and 13 (37.14%) were female. Mean age at presentation was 24.9 days. Total mean Pirani score at presentation was 4.91. Most of the cases required six casts for correction, with a mean of 5.77. Tenotomy was performed in 4 cases (11.43%). The mean number of days the child was in cast was 52.8. 6 cases (17.14%) had a relapse. All relapses were corrected by repeat casting. Mean Pirani score at 3 months follow-up was 0.081. In the accelerated Ponseti group, 15 children had bilateral clubfoot, 12 were unilateral on left side, and 8 were unilateral on right side. Among 35 children, 18 (51.43%) were male and 17(48.57%) were female. Mean age at presentation was 27.5 days.Totalmean Pirani score at presentation was 5.42. 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.

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