Is ponseti casting effective in neuromuscular clubfoot? A university hospital experience from eastern province in Saudi Arabia

Abstract

Objectives: Clubfoot deformity occurs in approximately one in 1000 newborns. In patients with neuromuscular disease, the clubfoot deformity differs markedly from that in idiopathic clubfoot with respect to its severity and higher rate of complications. We aimed to compare the effectiveness of the Ponseti serial casting technique in treating idiopathic and neuromuscular clubfoot. Methods: We performed a retrospective study of patients with clubfoot identified from a pediatric orthopedic clinic database, who were treated at our hospital from 2004 to 2018. The follow-up period for patients in both groups ranged from 8 to 12 years. The information obtained included age at presentation and number of casts required for deformity correction. We measured the severity of the clubfoot using the modified Pirani score before and after Ponseti treatment. Results: The initial number of participants was 117; upon applying our inclusion and exclusion criteria, only 39 patients from the idiopathic group and 10 from the neuromuscular disease-associated clubfoot group were included. The average age in weeks of the participants in the idiopathic group and the neuromuscular disease-associated clubfoot group at diagnosis was 1.79 and 1.80, respectively. Both groups had a similar mean modified Pirani score before and after the Ponseti treatment. Conclusions: Ponseti casting is an effective primary modality of management for clubfoot associated with neuromuscular diseases, as it is in idiopathic clubfoot, to achieve functional pain-free feet and reduce the number of surgical interventions needed.