Results of the Ponseti Technique of Manipulation Followed by Casting in Patients with Idiopathic Clubfoot

Abstract

Objective: Determination of outcomes of treatment of idiopathic clubfoot using Ponseti manipulation and serial castingStudy design: A cross-sectional studyPlace and Duration: This study was conducted at Jinnah Medical & Dental College/Sohail Trust Hospital Karachi from October 2021 to  October 2022.Methodology: The present study includes 150 children with clubfoot. All the patients were below the age of one year. The participants were treated by the technique of Ponseti manipulation and casting every week. The scoring of Pirani was used for the determination of deformity level. The scoring was done before and after the treatment. The interpretation of Pirani scoring is such that 0-1 is considered an excellent outcome, 1.5-2.5 is considered a good outcome, and more than 3 is considered a poor outcome. The Pirani score before and after the treatment was compared.Results: The present includes children with idiopathic club feet. A total of 74 (9.33%) children presented with bilateral club feet and 76 (50.66%) children presented with unilateral club feet. The total number of feet treated was 224. The mean age of the patients was 46.64±62.25 days. Out of 150 patients, 87 (58%) were male and 63 (42%) were female. Tendo Achilles tenotomy was performed in 121 (80.67%) children. The average number of casts was 5.43±1.76. The mean Pirani score before casting in the right foot was 4.96±1.2 and after casting was 0.14±0.42 (p <0.05). The mean Pirani score before casting in the left foot was 5.12±1.2 and after casting was 0.8±019 (p <0.05). Excellent results were seen in 184 (82.14%) of the feet and good outcomes were noted in 40 (17.86%) feet.Conclusion: The manipulation technique of Ponseti followed by casting proved to be highly effective in the correction of club foot deformity. Pirani score after the treatment indicated excellent outcomes in most of the patients.