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