Abstract
Congenital clubfoot is one of the most common musculoskeletal birth abnormalities, affecting 1–2 newborns out of every 1000 live births. However, it continues to test the skills of the paediatric orthopaedic surgeon because it has a notable tendency to relapse, regardless of whether the foot is treated conservatively or surgically.
Methods: It was prospective study, The study was conducted in the department of orthopaedics, Katihar Medical College & Hospital. A total of 36 feet confirmed by experts to have untreated Idiopathic Clubfoot were enrolled in the study. The severity of the deformity foe each foot was graded according to Pirani scoring, the period of the study from December 2019 to August 2021.
Results: The mean age of the study population was 4.416 months. Female cases were predominantly higher than male cases. Mean Pirani score before treatment 3.88±0.81 (range between 1.0– 6.0). 28.6 % of male patients and 22.7% of female patients needed percutaneous tenotomy. We have found significant correlation between before and after treatment of Clubfoot, The correlation factor was 0.687 and p value was <0.0001.
Conclusion: The accelerated Ponseti approach is a conservative treatment option for Congenital Talipes Equino varus that is just as effective as the standard Ponseti technique. Patients having a lower Pirani score at initial presentation respond better and faster to therapy than those with a higher Pirani score at first presentation. Treatment should begin as soon as possible, and the casting time frame can be significantly reduced by adopting an expedited procedure.
References
- Kite JH. Nonoperative treatment of congenital clubfoot. Clin Orthop. 1972;84: 29-38.
- Parker SE, Mai CT, Strickland MJ, Olney RS, Rickard R, Marengo L, et al. Multistate study of the epidemiology of clubfoot. Birth Defects Res A Clin Mol Teratol. 2009;85(11):897–904.
- Owen RM, Kembhavi G. A critical review of interventions for clubfoot in low and middle-income countries: effectiveness and contextual influences. J Pediatr Orthop B. 2012;21(1):59–67.
- Cowell HR. The management of club foot. J Bone Joint Surg Am. 1985;67:991-2.
- Crawford AH, Gupta AK. Clubfoot controversies: complications and causes for failure. Instr Course Lect.1996;45:339-46.
- Laaveg SJ, Ponseti IV. Long-term results of treatment of congenital club foot. J Bone Joint Surg Am. 1980;62:23-31.
- Cooper DM, Dietz FR. Treatment of idiopathic clubfoot. A thirty-year follow-up note. J Bone Joint Surg Am. 1995;77: 1477-89.
- Pirani1, D. Hodges and F. Sekeramayi A reliable & valid method of assessing the amount of deformity in the congenital clubfoot deformity.J Bone Joint Surg Br 2008 vol. 90-B no. SUPP I 53.
- Swann M., Lloyd – Roberts G.C., Catterall A. The anatomy of uncorrected club feet. A study of rotation deformity. J Bone J Surg 1969; 51-B: 263-9.
- Kite J.H.: Non operative treatment of congenital clubfoot. Clin Orthop. 1972; 84: 29-36.
- Wayne –Davies R. Family studies and cause of congenital club foot. J Bone J Surg. 1964; 46-B: 445-63.
- Morcuende JA, Abbasi D, Dolan LA, Ponseti IV. Results of an accelerated Ponseti protocol for clubfoot. J Pediatr Orthop. 2005 Sep-Oct; 25(5):623-6.
- Herzenberg JE, Radler C, Bor N. Ponseti versus traditional methods of casting for idiopathic clubfoot. J Pediatr Orthop. 2002 Jul-Aug; 22(4):517-21.
- Harnett P, Freeman R, Harrison WJ, Brown LC, Beckles V. An accelerated Ponseti versus the standard Ponseti method: a prospective randomised controlled trial. J Bone Joint Surg Br. 2011 Mar; 93(3):404-8
Corresponding Author
Dr Rishab Dubey
Junior resident, Department of Orthopaedics, Katihar Medical College & Hospital Katihar