Clubfoot Treatment By Ponseti Method

Objective: to document the outcome of ponseti method in the treatment of clubfoot. study design: observational-descriptive study. place and duration: department of orthopedic surgery and traumatology,liaquat university of medical and health sciences (lumhs) jamshoro,sindh - pakistan,from january 2007 to december 2010 (4-years). methodology: clubfeet were treated by ponseti technique. pirani score was recorded for all subjects at the time of presentation and a foot was considered fully corrected when scored 00.5. immediately after the removal of last cast,foot abduction braces were used. follow-up pattern was at two weeks,at three months,then at four month interval up to 3-years age,then at six month interval up to 4-years age,and then once a year. any relapses were treated accordingly. tenotomy was repeated in equines,whereas castings were repeated in adduction of forefoot,intoeing and cavus. results: during the study period 49 children presented 71 clubfeet with 27 (55.1%) unilateral and 22 (44.9%) bilateral cases. the mean pirani score at the time of presentation was 5.44. majority (63.38%) feet required casting up to 5-weeks and in 69.01% feet complete correction was acquired by five casts (mean 5.6 casts). achilles tenotomy was performed in 65 (91.55%) feet. pirani score of 0-0.5 was achieved in 69 (97.18%) cases within 1-year follow-up. thirteen (18.31%) cases of relapse were reported. among these,2 (2.82%) cases of equinus underwent repeat tenotomy; whereas 7 (9.86%) cases of adduction,3 (4.23%) cases of cavus and 1 (1.41%) case of intoeing were treated by repeat casting. conclusion: ponseti method can be used in our setup with excellent correction of clubfoot deformity,and surgical complications can be minimize by this technique.