Results of Ponseti Casting for Clubfoot in a Tertiary Public Hospital

Abstract

Introduction. Congenital talipes equinovarus (CTEV), also called clubfoot, is one of the most common orthopedic congenital anomalies. However, there is no formal study of the condition here in the Philippines, and data is sparse regarding the epidemiology, treatment, and outcomes in similar third-world countries.
 Methods. Retrospective review of data of clubfoot patients seen at the Philippine General Hospital (PGH) Clubfoot Clinic from 2006 up to the present.
 Results. Records from 75 patients treated at the PGH Clubfoot Clinic from 2010-2016 were reviewed. Idiopathic clubfoot comprised 76% of the patients, while syndromic clubfoot comprised 24%. A good outcome of the Ponseti method was seen in 82% and 88% of the idiopathic and syndromic clubfoot patients, respectively. Idiopathic clubfoot cases that had good outcomes required an average of 11.84 casts to tenotomy or bracing, which was not statistically significant compared to 9.55 average sessions for syndromic clubfoot (p=0.21). The initial Pirani scores for both cases were not significantly different (p=0.95). Idiopathic cases with poor outcomes needed less casting sessions (4.45) because the decision to operate was made early. Age was not found to significantly affect the outcome of treatment for idiopathic clubfoot (p=0.20) and syndromic clubfoot (p=0.64).
 Conclusion. Ponseti casting was found to be effective in treating both idiopathic and syndromic clubfoot patients. The number of sessions did not differ significantly between the two.