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Category: Volume 08 Issue 02 February 2020
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Title: Comparative Study of Accelerated Ponseti Cast with Standard Ponseti Cast

Authors: Dr Malik Naseer Ahmad, Dr Abdul Ghani, Dr Rajinder Singh, Dr Mohammad Farooq Bhatt, Dr Sheikh Aisha Shabir, Dr Khalid Nisar, Dr Tanveer Ah Bhatt, Dr Imtiyaz Ah Beigh

 DOI: https://dx.doi.org/10.18535/jmscr/v8i2.68

Abstract

Introduction: Congenital talipes equinovarus (CTEV) commonly known as Clubfoot is a common birth defect that affects one in thousand live births. In past attempt at correction, based on forceful manipulations, resulted in incomplete corrections as well as iatrogenic deformities. With the advancement in understanding of kinematics and pathoanatomy of the CTEV, the Ponseti developed a novel method of correction, which has gained wide acceptance worldwide. Various modification have been done in terms of frequency of casting with evidence to suggest that accelerated frequency of cast changes has comparable outcomes to those of the conventional Ponseti method. Our study was undertaken to compare the results of Standard Ponseti method with that of the Accelerated Ponseti method in management of idiopathic CTEV.

Method & Material: Only idiopathic cases of both gender less than 1 year age were included in double-blind randomized prospective comparative study was conducted in the Department of Orthopaedics of Govt Medical College and Hospital, 55 patients with total 80 clubfeet, who met the inclusion criteria were included in the study.

Result: In our study of 55 patients with 40 idiopathic clubfeet in each group. The two groups were almost comparable with Pirani score of 4.69 in accelerated group and 4.88 in standard group respectively at the initiation of the casting. Mean duration of treatment from the first cast to tenotomy in accelerated ponseti group was 2.21 weeks and in standard ponseti group was 5.8 weeks respectively. Post cast Pirani score was 0.48 in accelerated group and 0.5 in standard group respectively. All the patient were followed for an average period of 15 month (12-18 month). No major complications were recorded in any group. The two study groups, the traditional and the accelerated Ponseti groups had nearly equivalent results with significant reduction in the correction time in the accelerated Ponseti group.

Conclusion: The clubfoot in developing countries has social stigma, the early and the promising result of the accelerated method of ponseti casting has a dramatic impact on both parents and the treating orthopaedician. The accelerated ponseti casting has remarkably reduced the overall duration of the treatment of Ponseti casting without any complication. It has reduced the overall economic burden on the poor patient by reducing the number of days of work lost as well as the total expenditure on the travel .

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Corresponding Author

Dr Malik Naseer Ahmad