Ponseti method for eongenitul tulipes equlnovarus in different ages

Abstract

Objective To observe the therapeutic effects of Ponseti method for congenital talipes equinovarus(CTE) among different age groups. Methods Five hundred and forty-four feet in 378 cases of CTE were treated with Ponseti method. According to the age differences, they were divided into 5 groups:①the neonatal group (≤28 d) : 55 feet in 36 cases; ②the younger infancy group (29 d～180 d) : 262 feet in 185cases; ③the older infancy group (181d-12months) : 113 feet in 81 cases; ④the toddler age group (1～3 years) : 78 feet in 52 cases; ⑤the childhood group (3 years) : 36 feet in 24 cases. According to the initial treatment background, patients were divided into two groups, the initial treatment group (177 feet in 125 cases) and the re-treatment group (367 feet in 253 cases). The deformation degree of CTE was evaluated by the Pirani scoring system. A scoring of 0～0. 5 was regarded as excellent. For each group, we evaluated the percentage of excellence according to the Pirani score, the number of casts used, and the percentage of percutaneous achillotenotomy. The results were compared among different groups. Results The percentage of excellence in all patients was 97.98%,and in the childhood group it was lower than that in the other groups (P<0.01), but it showed no significant differences between the initial treatment group and the re-treatment group (P 0.05). There were significant differences in the number of casts used among each group (P<0.001). The percentage of percutaneous achillotenotomy showed significant differences between each group before 1-years old, but after 1-years old there were no differences between each group. Both the number of casts used and the percentage of percutaneous achillotenotomy in the initial treatment group were more than those in the re-treatment type. There was obvious difference between these two groups (P <0.01). Five hundred and twelve feet in 353 cases were followed up for an average of 29 months. Ninety-six feet in 67 cases recurred, the percentage of recurrence showed no differences among different age groups(P0.05). Conclusions Ponseti method is not only suitable for the treatment of young CTE patients, but also applicable for older CTE patients and CTE patients with recurrence. Key words: Equinus deformity; Age factors