Managing clubfoot with Ponseti method: Our experience with children upto 3 years of age

Abstract

Introduction: Ponseti method has become the mainstay of congenital clubfoot treatment in children presenting at early age. The initial efficacy rate of Ponseti method reaches almost 100%. The Ponseti method is also effective in older children with varied degree of success and preventing open joint surgery in almost every case. The Pirani method of evaluating the deformity and treatment outcome is easy and fairly reproducible and corresponds to the functional outcome of the treated feet. Aim: The present study aims at elucidating the efficacy of Ponseti method of clubfoot correction in an inexperienced hand and evaluating the feasibility and worth of Pirani severity scoring system in deformity and treatment evaluation. Materials and Methods: This is a prospective study carried out ii our institution Shri Guru Ram Rain Medical College Dehradun, India over a period of 2 ½ years from June 2015 to December 2017 and includes 44 idiopathic Clubfeet corrective cast application at weekly interval as per Ponseti protocol and were assessed with Pirani scoring system. The cases were followed up regularly at least for 6 months. Results: Following Ponseti protocol, we were able to achieve success rate of 95.45%. We experienced only a few minor complications such as plaster sores and overcrowding of toes that too in initial phase of study. Conclusion: Ponseti method is truly the gold standard of clubfoot management. Using Ponseti method, one can expect to achieve almost 100% success rate. It is also fairly effective in older children though with varied outcome or can at least prevent open joint surgery in them. The Pirani scoring system is clinical based, easy to apply and is in sync with Ponseti method. Keywords: Clubfoot, Ponseti method, Pirani score.