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Category: Volume 07 Issue 04 April 2019
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Title: Management of Clubfoot with Accelerated Ponseti Casting Method at Tertiary Care Hospital, GMC Jammu India

Authors: Dr Malik Naseer Ahmad, Dr Abdul Ghani, Dr Sheikh Kalid Nissar

 DOI: https://dx.doi.org/10.18535/jmscr/v7i4.109

Abstract

Objective: The study was to evaluate the outcome of accelerated ponseti cast technique for clubfoot at the tertiary care hospital, GMC Jammu india.

Methodology: We conducted a prospective randomised controlled trial to study the results of an accelerated ponseti twice-weekly casting method for the treatment of idiopathic congenital talipes equinovarus at tertiary care hospital from June 2016 to October 2018. A total of 40 patients (57 feet) were included in the study. Patient’s feet were scored according to modified Pirani scoring system. On each cast removal, improvement in Pirani score was noted. Primary outcome measure was deformity correction.

Results: Total 40 patients with 57 clubfoot include in our study There were 27 males (67.5%) and 13 (32.5%) females. Bilateral deformity was present in 17(42.5%) patients where as 23 (57.5%) patients had unilateral clubfoot. Average Pirani score before casting was 4.69 (3.5-6). Average Pirani score post-treatment was 0.48. The average number of cost applied was 5.14 (4-7) .Out of 57 feet, tenotomy was done to 53 feet (92.98%). The average time required for correction from onset of ponseti cast till correction of equinus is 15.5 days (11–20 days). Out of 57 feet, 52 feet (91.22%) were treated successfully using the accelerated Ponseti method.

Conclusions: A twice-weekly Ponseti casting protocol enables completion of the casting period earlier than the standard Ponseti method.

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Corresponding Author

Dr Malik Naseer Ahmad

Resident Orthopaedics, GMC Jammu, India