Abstract
Background. The standard Ponseti method is a mainstay of treatment for children with congenital talipes equinovarus (CTEV); involving weekly manipulation and long-leg casting, this approach has proven to produce good long-term outcomes. However, it takes approximately 45 weeks to correct all deformity components, making compliance a challenge for patients with limited economic resources and difficulty reaching healthcare centres.
 Aim. This study aims to compare treatment outcomes between standard Ponseti and an accelerated protocol applying the same casts but changing them more frequently, every 2-5 days for the CTEV pathology.
 Methods. A systematic search was conducted based on PRISMA guidelines to identify relevant studies through PubMed, Google Scholar, and Cochrane Database. A total of seven studies (324 patients, 408 feet) were included in the meta-analysis. Five outcomes were compared between the two procedures: post-procedure Pirani score, relapse rate, tenotomy rate, number of casts, and total duration of treatment.
 Results. For total duration of treatment, the accelerated Ponseti method was superior to standard Ponseti (24.25 vs. 41.54 days, p 0.00001). On the other hand, it achieved comparable efficacy as measured by post-procedure Pirani score (1.01 vs. 0.87, p = 0.19). Furthermore, the two procedures were also comparable in terms of the total number of casts needed (4.94 vs. 5.05, p = 0.76), tenotomy rate (73.29% vs. 65.27%, p = 0.07) , and relapse rate (27.72% vs 25.23%, p = 0.56).
 Conclusion. Accelerated Ponseti offers similar efficacy and shorter duration of treatment compared to the standard Ponseti technique.
Highlights
The standard Ponseti method is a mainstay of treatment for children with congenital talipes equinovarus (CTEV); involving weekly manipulation and long-leg casting, this approach has proven to produce good long-term outcomes
This study aims to compare treatment outcomes between standard Ponseti and an accelerated protocol — applying the same casts but changing them more frequently, every 2-5 days — for the CTEV pathology
Five outcomes were compared between the two procedures: post-procedure Pirani score, relapse rate, tenotomy rate, number of casts, and total duration of treatment
Summary
СРАВНЕНИЕ СТАНДАРТНОГО И УСКОРЕННОГО МЕТОДОВ ЛЕЧЕНИЯ ИДИОПАТИЧЕСКОЙ ВРОЖДЕННОЙ КОСОЛАПОСТИ ПО ПОНСЕТИ: СИСТЕМАТИЧЕСКИЙ ОБЗОР И МЕТААНАЛИЗ. Сравнение стандартного и ускоренного методов лечения идиопатической врожденной косолапости по Понсети: систематический обзор и метаанализ // Ортопедия, травматология и восстановительная хирургия детского возраста. Стандартный метод Понсети составляет основу лечения детей с врожденной эквиноварусной деформацией стопы. Цель — сравнение результатов ускоренного и стандартного методов консервативного лечения врожденной эквиноварусной деформации стопы по Понсети. Протоколы сравнивали по пяти параметрам: оценке по шкале Пирани после лечения, частоте рецидивов, количеству тенотомий, количеству гипсовых повязок и общей продолжительности лечения. При этом ускоренный метод Понсети был сравним по эффективности со стандартным методом, которую определяли по шкале Пирани после окончания лечения (1,01 против 0,87, p = 0,19).
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