Kamran Asghar, Muhammad Mobushir, Hamza Fareed, Kashif Abbas, Muhammad Nasir Nawaz, Muhammad Salim, Nouman Maqbool

Comparison of Results of Standard Versus Accelerated Ponseti Method for Congenital Club Foot Deformity

Kamran Asghar, Muhammad Mobushir, Hamza Fareed, Kashif Abbas, Muhammad Nasir Nawaz, Muhammad Salim, Nouman Maqbool



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ABSTRACT

Objective: To compare the outcome of standard versus accelerated Ponseti method for congenital club foot deformity.

Study Design: Randomized Controlled Trial

Place and Duration: Department of Orthopedics Surgery, Fouji foundation hospital, Rawalpindi, duration was six months from February 2021 to July 2021.

Methodology: Total 80 patients of either gender presented with congenital club foot deformity were enrolled. Patients’ ages were ranging between 1-6 months. Patients will be randomly divided into two groups by using lottery method. Group-A (n=40) patients were received accelerated Ponseti techniques and Group-B (n=40) patients had received standard Ponseti techniques. The cast were changed twice weekly in the accelerated group and once weekly in the standard group. Patients will be followed-up in OPD after 1, 4, 8 and12 weeks.After 12 weeks, patients will be evaluated for Pirani and Dimeglio scores by using modified functional rating system score.

Results: There were 25 (62.5%) male and 15 (37.5%) patients were females in Group A with mean age 2.36±1.48 months. In Group B, 23 (57.5%) patients were males while 17 (42.5%) were females with mean age 2.48±1.74 months. In group A, mean Pirani score at presentation was 6.48±2.76 and in group B it was 6.58±2.66. Mean number of cast required in group A was 6.68±1.74 and in group B it was 6.14±1.56. At end of treatment men Pirani score in group A and B was 0.48±0.36 and 0.54±0.32, no significant difference was found between both groups with p-value >0.05. At presentation, mean Dimeglio score in group A and B was 11.04±2.48 and 11.56±2.74, at follow-up it reduces to 0.86±0.48 and 0.88±10.56. At final follow-up, 22 (55%) patients had excellent and 18 (45%) had good functional outcomes in group A and in group B 20 (50%) had excellent, 18 (45%) had good and 2 (5%) had fair functional outcomes.

Conclusion: It is concluded that both accelerated and standard techniques had comparable efficacy and safety for club foot deformity.

Keywords: Club Foot Deformity, Standard Ponseti, Accelerated Ponseti Method, Pirani Score



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