2022, Volume 8 Issue 1
Standard and accelerated ponseti technique in management of idiopathic congenital talipes equinovarus: A comparative study
Author(s): Dr. Shamim Ahmed Barbhuiya, Dr. Aswin B Nair TU and Dr. Arijit Dhar
Abstract: Introduction: Congenital talipes equinovarus (CTEV) is one of the most common deformities of foot and ankle. Incidence of CTEV is around 1 in every 1000 live births. Males are affected twice as often as females. Bilateral deformities occur in 50% of cases and in unilateral cases, right foot has predominance. Components of Congenital talipes equinovarus are cavus, forefoot adduction, hindfoot varus, ankle equinus. Goal of clubfoot management is to produce and maintain a painless, functional, mobile and callosity free, normal shoeable foot. In an accelerated ponseti technique, cast is applied twice weekly on fixed days instead of one week. This study compares the results of Standard Ponseti technique with Accelerated Ponseti technique in management of idiopathic CTEV.
Materials and Methods: A hospital based prospective randomized comparative study was conducted in the Dept. of Orthopaedics of Silchar Medical College,Silchar, Assam from 1stJune 2020 to 31st may 2021. Total of 50 cases were selected randomly, randomization was done, 25 were treated by Standard Ponseti and 25 were treated by Accelerated Ponseti technique.
Results: Mean Pirani score at presentation in standard Ponseti group was 5.25±0.76, and in accelerated Ponseti group it was 5.37±0.65, with p-value indicating that two groups did not have significant difference. In standard Ponseti group, the treatment time in plaster ranged from 28-56 days, and in accelerated Ponseti group it ranged from 14-31 days.
Discussion: Modification in frequency of casting has shown that the efficacy remains unchanged but correction of deformity occurs in a shorter span of time. Reduction in duration of treatment will help to improve compliance among parents.
Conclusion: Ponseti method has shown good results in idiopathic as well as syndromic CTEV. This Study shows that Accelerated Ponseti method is equally effective as Standard Ponseti method in treatment of idiopathic CTEV with the benefit of reduction in treatment time.
