Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Management of idiopathic clubfoot in toddlers by Ponseti's method

Verma, Ananda; Mehtani, Anilb; Sural, Sumita; Maini, Lalita; Gautam, Virender Kumara; Basran, Sukhwinder Singha; Arora, Sumita

Journal of Pediatric Orthopaedics B: January 2012 - Volume 21 - Issue 1 - p 79–84
doi: 10.1097/BPB.0b013e328347a329
REGULAR SUBMISSIONS
Buy

The Ponseti method has been reported to have successful results in clubfoot patients less than 6 months of age but the literature on its efficacy in older clubfoot patients still remains sparse. In our study, we prospectively evaluated 55 clubfeet (37 patients) to determine clinically whether the Ponseti method is effective in the management of clubfoot in older children between the age of 12 and 36 months (mean: 24.8 months). All the patients belonged to moderate or severe grades of deformity as per the Pirani scoring. Painless, supple, plantigrade and cosmetically acceptable feet were achieved in 49 clubfeet. Seven patients (seven feet) developed recurrence of adduction, varus and equinus deformity whereas three patients (five feet) developed isolated recurrence of equinus deformity. These seven patients responded to repeat treatment and obtained satisfactory outcome. Four of these seven patients underwent tibialis anterior transfer to third cuneiform for dynamic supination. Three patients, those developed isolated recurrence of equinus deformity, underwent repeat tenotomy. One foot achieved satisfactory amount of dorsiflexion, three feet underwent tendoachilles lengthening whereas another foot underwent posterior release to obtain satisfactory dorsiflexion. Six to 12 numbers of casts (mean: 10) were required to obtain correction of clubfoot deformities. Mean period of immobilization in a cast was 13.9 weeks (10–15 weeks). We found that the Ponseti method is effective in children between the age of 12 and 36 months.

aDepartment of Orthopaedic Surgery, Maulana Azad Medical College and Associated Lok Nayak Hospital

bDepartment of Orthopaedics, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India

Correspondence to Dr Anand Verma, MS, DNB, Senior Resident, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi 110002, India Tel: +91 9582435030; e-mail: anand.mamc@gmail.com

This study was carried out at Department of Orthopaedic Surgery, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi-110002, India.

© 2012 Lippincott Williams & Wilkins, Inc.