Predictors of Success in Ponseti Casting, A Single Center Cross-sectional Study

Abstract

Background: Congenital talipes equinovarus (CTEV), also known as club foot deformity, is a common deformity with an estimated incidence of around 1 in 1000 live births. The deformity consists of four components: Ankle equinus, hindfoot varus, forefoot adductus, and midfoot cavus. Various approaches exist to correct CTEV, with most authorities advocating a conservative closed reduction approach with serial casting. Objective: Pirani scoring has been shown to correlate with the severity of CTEV and has been verified to track response to casting treatment. This study aimed to identify the relationship between initial presenting Pirani scores and other factors on the final Pirani score and the need for surgical intervention for patients managed with Ponseti casting in a single-center observational study design. Methods: A total of 24 patients were followed across the duration of the study and serially assessed with the Pirani scoring system. The scores were charted and studied to determine patterns that predict the success of Ponseti casting in those children. Results: The data showed that tenotomy is most likely corrective of the deformity in those with higher PS. While the age of diagnosis and age of casting were not significantly impactful, careful follow-up and discussion of goals with the family members are essential for expected outcomes, especially for those hesitant to undergo surgical interventions and those with higher Pirani Scores. Keywords: Clubfoot; Humans; Child; Congenital equinovarus; Foot Deformities, Acquired; Foot Deformities