EFFECTS OF MANIPULATION AND CASTING OF PONSETI METHOD OUTCOME IN CHILDREN WITH IDIOPATHIC CLUBFOOT.

http://doi.org/10.46536/jpumhs/2023/13.01.388

Abstract

Abstract

Introduction: One of the most prevalent paediatric foot deformity is clubfoot. Idiopathic

clubfoot is a condition for which there is no known cause. The Ponseti Technique became the

best choice for treating clubfoot all around the world. The Ponseti method of treating idiopathic

clubfoot includes weekly serial manipulations and castings until the foot can be abducted to 60

degrees. The patient is subsequently placed in a foot abduction orthosis to maintain the

correction made and prevent the deformity from relapsing after Achilles tendon tenotomy and

casting. Objective: To determine the effects of manipulation and casting of Ponseti method

outcomes in children with idiopathic clubfoot. Methodology: This descriptive cross sectional

study was conducted in orthopaedic department of PMCH Hospital Nawabshah from August

2022 to February 2023. 100 children of both genders with idiopathic clubfoot were included.

After enrolment complete history and physical examination of all children were carried out.

Informed written consent was taken from parents or guardians of the children. Data were entered

in excel sheet and analyzed in SPSS version 21. Qualitative variables were presented in

percentage and frequencies while quantitative variables were presented in mean and standard

deviation. Paired sample t test was applied. Results: According to our results, 100 children with

clubfoot were included in this study. 50 children were male and 50 children were female. The

mean ages of children were 4.02 months. Bilateral clubfeet were 53% and unilateral clubfoot was

47%. The right club foot was 32% and 20% was left side. The average no: of cast were 5.45.

41% of children need tenotomy. The initial Pirani score was 3.140. The final Pirani score mean

was 0.60. Post stratification data analysis revealed statically significant between initial and final

Pirani score with P-value (0.001). Conclusion: Clubfoot can be effectively treated with the

Ponseti method of casting and manipulation.. It is the simplest approach. Therefore, we advise

using this method as the first line of treatment for infants with idiopathic club feet.