Comparison of Results of Standard Versus Accelerated Ponseti Method for Congenital Club Foot Deformity

Abstract

Objective: To compare the outcome of standard versus accelerated Ponseti method for congenital club foot deformity. Study Design: Randomized Controlled Trial Place and Duration: Department of Orthopedics Surgery, Fouji foundation hospital, Rawalpindi, duration was six months from February 2021 to July 2021. Methodology: Total 80 patients of either gender presented with congenital club foot deformity were enrolled. Patients’ ages were ranging between 1-6 months. Patients will be randomly divided into two groups by using lottery method. Group-A (n=40) patients were received accelerated Ponseti techniques and Group-B (n=40) patients had received standard Ponseti techniques. The cast were changed twice weekly in the accelerated group and once weekly in the standard group. Patients will be followed-up in OPD after 1, 4, 8 and12 weeks.After 12 weeks, patients will be evaluated for Pirani and Dimeglio scores by using modified functional rating system score. Results: There were 25 (62.5%) male and 15 (37.5%) patients were females in Group A with mean age 2.36±1.48 months. In Group B, 23 (57.5%) patients were males while 17 (42.5%) were females with mean age 2.48±1.74 months. In group A, mean Pirani score at presentation was 6.48±2.76 and in group B it was 6.58±2.66. Mean number of cast required in group A was 6.68±1.74 and in group B it was 6.14±1.56. At end of treatment men Pirani score in group A and B was 0.48±0.36 and 0.54±0.32, no significant difference was found between both groups with p-value >0.05. At presentation, mean Dimeglio score in group A and B was 11.04±2.48 and 11.56±2.74, at follow-up it reduces to 0.86±0.48 and 0.88±10.56. At final follow-up, 22 (55%) patients had excellent and 18 (45%) had good functional outcomes in group A and in group B 20 (50%) had excellent, 18 (45%) had good and 2 (5%) had fair functional outcomes. Conclusion: It is concluded that both accelerated and standard techniques had comparable efficacy and safety for club foot deformity. Keywords: Club Foot Deformity, Standard Ponseti, Accelerated Ponseti Method, Pirani Score