Effectiveness of the Ponseti Technique in the management of clubfoot

Abstract

Background: Clubfoot is a common developmental anomaly of the musculoskeletal system and it remains a burden to developing countries due to lack of appropriate medical care, poverty and ignorance. The Pirani scoring system is an instrumental tool for assessing both the severity of the deformity, and the progress of treatment.

Objectives: To determine the effectiveness of the Ponseti technique in clubfoot correction in our centre.

Methodology: This was a prospective study carried out in a tertiary hospital. Ethical clearance was obtained from the hospital Ethics Committee. Patients who met the inclusion criteria were randomly selected. The Pirani score of all feet were obtained before initial manipulation was commenced, and was also done at each follow up visit until correction was achieved.

Results: A total of 50 patients (64 clubfeet) were recruited. The mean Pirani score at presentation was 4.33± 1.56 while the mean number of casts used for correction was 7.61 ±2.87. Clubfoot correction using the Ponseti technique was achieved in 58 (90.6%) clubfeet. Tenotomy was done in 37 (57.8%) clubfeet.

Conclusion: From the results of this study, it is concluded that the Ponseti technique is an effective method for clubfoot correction. The Pirani scoring system is also an effective tool in monitoring progress obtained in the clubfoot during correction. It is therefore recommended that the Ponseti technique be used routinely in the treatment of clubfoot.

Keywords: CTEV, Ponseti technique, Pirani score, Congenital feet malformation