Javed Iqbal.
Management of clubfoot using Ponseti method.
Pak Paed J Jan ;31(4):201-5.

Objective: The purpose of this study is to evaluate the efficacy of Ponseti Method in reducing extensive corrective surgery rate for congenital idiopathic clubfoot. Study Design: Descriptive study Materials & Methods: This case series was conducted from September, 2005 through March, 2007. A total of 67 patients (101 club feet) were evaluated. The age of patients at the start of treatment was under one month. All patients were treated by serial manipulation and casting as described by Ponseti. All components of deformity were corrected simultaneously except equinus which was corrected last. The cavus was corrected together with adduction by supination and abducting the forefoot in proper alignment with the hindfoot. The heel varus was corrected with foot abduction under the talus. Finally the equinus was corrected by dorsiflexion of the foot. Cast was changed after 7 to 10 days. Percutaneous tendoachilles tenotomy was carried out in 65 (97%) of cases under local anesthesia. Later on Denis Brown shoes were advised. Main outcome measures include initial correction of deformity an extensive corrective surgery rate & relapses. Results: Clubfoot correction was obtained in 60 (90%) cases. Average time for full correction of deformity was 49 days (ranging 33-91 days). In 2 cases satisfactory position was not achieved and there was relapse in 5 cases.These cases underwent corrective surgery subsequently. Conclusion: The Ponseti Method is safe and effective treatment for congenital idiopathic clubfoot, and radically decrease the need for extensive corrective surgery.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com