Management of Congenital Talipes Equinovarus with Ponseti Technique in Children Under 2 Years of Age

Abstract

Abstract
Background and Objectives: CTEV is a complex congenital deformity of the foot and occurs due to the
confluence of genetic & environmental factors. If it is not treated promptly and accordingly, it limits patient
mobility and results in a painful foot. In most cases, it is treated conservatively using the Ponseti technique.
This method was developed by a Japanese orthopedic surgeon Ignatio Ponseti who successfully treated
CTEV in infants without extensive surgery. It is a manipulative technique with percutaneous release of
tendoachilles that allows the ankle to obtain correction. This study was conducted to assess the functional
outcomes of CTEVmanagement by Ponseti method.
Methods: Ethical approval was obtained from the Ethical Review Board Of Services Hospital Lahore. This
descriptive study was conducted at the department of orthopedic surgery from December 2018 to December
2020. A total number of 120 patients having CTEV deformity of the foot, aged less than 2 years, were
included in the study. From these, 70 children had bilateral foot involvement. It was treated with 5-7 casts
with each cast applied for 07 days according to the Ponseti method. In the final cast, a percutaneous Achilles
Tenotomy was performed, where the deformity was restricted to 10 degrees from the neutral. After
completion of casts, each patient was braced with Foot Abduction Brace.
Results: We used Pirani Score for pre- and post-operative assessment of correction of deformity via Ponseti
method. There were 91% excellent results achieved through this method, whilst 6% of patients had good
results and 3% had poor results.
Conclusion: Ponseti technique has got good functional & cosmetic results. It is economical and easy to
apply.
Key words: Club foot, Pirani Shafique score, Ponseti technique, CTEV