Abstract

Clubfoot is a common congenital deformity and expected to affect 1.2 out of every 1000 live births in India. This is a huge number of instances, and their management necessitates special attention. The Conventional Ponseti techniques currently the gold standard approach to treat clubfoot which entails changing the plaster every week and gradually abducting the foot. Modification of the Ponseti method, The accelerated Ponseti method, the manipulation method remains the same, but plaster is changed two or three times a week, which can shorten the time immobilized in plaster with increased parents compliance. In this study comparison between conventional and accelerated ponseti technique in management of Clubfoot and effect of initial pirani scoring on final outcome were assessed. Materials and Methods: A prospective study was done in 50 feet (39 patients), who were randomly allotted with 25 feet in conventional group and 25 feet in accelerated group. In conventional group, manipulation and casting were done at weekly intervals, whereas in accelerated group, the same was done at 3 days interval. The initial and final Pirani score, number of casts required, duration of casting and relapse after treatment were recorded for all cases in both the groups and the results were analyzed. Results: The mean Pirani score difference between the first and last cast of the conventional method was 5.00±0.00 while the Pirani score difference of the accelerated method was 4.96±0.14. No significant difference was found in the mean Pirani score difference between the two groups (p=0.136). The mean total number of casts of the conventional method was 6.58±0.89 while the total number of casts of the accelerated method was 9.90±0.63. So the mean total number of casts in the conventional method was found to be significantly less than the accelerated method (p<0.001). The mean total duration from 1st cast to tenotomy of the conventional method was 39.05±6.23 days while the mean total duration from 1st cast to tenotomy of the accelerated method was 26.70±1.90 days. Conclusion: The result of this study shows that the Accelerated ponseti method is equally effective as Standard Ponseti method in treatment of idiopathic CTEV with the benefit of reduction in treatment time and it will also help to improve compliance among parents.

Description