MIDTERM RESULTS OF PONSETI METHOD IN CONGENITAL CLUB FOOT; SUBJECTIVE AND OBJECTIVE OBSERVATIONAL STUDY OF CHILDREN.

Abstract

Objective: To analyze midterm results of Ponesti technique in congenital club foot. Material And Methods: After taking informed consent, the parents of the children who had a club foot (congenital talipesequinovarus) deformity, treated in our club foot clinic, Dow University hospital by a single orthopedic surgeon during the period of Jan 2020 to March 2020 were included in the study.It is a cross sectional study, with a sample size of 292, sampling technique was non probability type. The study was conducted after taking approval from Institutional review board, Dow University of health sciences. Research team members, who are ponseti trained practitioners, filled questionnaire by asking the parents directly in the clinic. Inclusion criteria was children who have completed stage of casting and bracing (treated with Ponseti technique) whose affected children are less than 5 years of age. Exclusion criteria were Children with Syndromic club foot. Children with recurrence and relapse of club foot requiring surgery, Children who have been treated surgically. Final data were imported and analyzed by SPSS v.16. Results: Mean Pirani score was 0.4164.Calf circumference of foot is normal in 254(82.7%) where as it was reduced in 37(12.1%). Regarding length of foot, it came out to be normal in 253(82.4%) babies where as in 38 (12.4%) it was small. Satisfaction level of the parents from Ponseti technique was 278(90.6%) and 149(4.6%). Foot function was 282(91.9%) normal and only 9(2.9%) had function below normal. Regarding limitations in routine activities, 279(79%) had no limitations, 11(3.1%) had occasional limitation and only 2(0.6%) had usual limitation.Regarding pain 278(78.8%) had no pain, 9(2.5%) had occasional pain on strenuous work and 5(1.4%) had occasional pain on routine work and none had always pain on walking. Conclusion: Ponseti technique is an efficient and effective method of treatment in clubfoot. The success rate of this method in this study is more than 90% in midterm follow up. The subjective and objective outcome equally shows satisfactory results. Therefore, it is highly recommended that children born with clubfoot should be treated with Ponseti technique soon after birth in order to achieve complete correction and to prevent the complications caused by this deformity.