ABSTRACT

Background: Ponseti technique is reported to be associated with have excellent results in the management of clubfoot cases under 6 months age group. There was regional knowledge gap for cases of 2-5 years age group.

Aim: To observe and assessing the Ponseti’s technique’s role in the management of idiopathic talipes equinovarus among children of age range of 2-5 years.

Study Design: Prospective study

Place and Duration of Study: Department of Orthopedic, LUMHS from 1st January 2016 to 31st December 2017.

Methodology: Twenty five children with unilateral and bilateral TEV age between 2-5 years were included. Children <2 and> 5 years, congenital anomalies as well as syndromic feet were excluded. Patients’ parents were explained the procedure and consent was taken and evaluation of TEV was made using Pirani Scoring at initial level and after weekly casting, manipulation and assessments.

Results: The mean was 3.2±.9 years, 17 (68%) were boys and 8 (32%) were girls. The bilateral involvement was seen in 12 (48%) cases while 13 (52%) cases were unilateral. Mean Pirani score before treatment were 5.67±0.81 and post-treatment Pirani score was 0.50 ± 0.33 with significant difference p-value 0.0001.Excellent results were achieved in 18 (48.64%) feet having a Pirani score of 0(zero), while good results were seen in 16 (43.24%) feet with Pirani score of 0.5- 1 whereas poor results were found in 3 (8.10%) feet with no correction and Pirani score was >1. Percutaneous Achilles tenotomy was required in 30 (81.08%) feet while7 (18.9%) feet were corrected with plaster cast alone whereas 3 (8%) feet were not corrected. Skin excoriation was observed in 01(2.7%) foot and 2 (5.4%) feet developed blister formation.

Conclusion: Congenital talipes equinovarus is well managed with Ponseti technique with above 90% success rate and less than 10 failure rates

Key words: Talipes Equinovarus, Pirani score.Ponseti Technique