Treatment of Clubfoot by Ponseti Method:Our Experience

Historically clubfoot was recognized and documented since the time of ancient Egyptians. Hippocrates introduced Talipeseqinovarus into medical literature in 400 B.C. Although different treatment methods have been described with varying degrees of success, Ponseti method in clubfoot correction with its well-documented long-term success rate, is becoming an accepted treatment method all over the world.

The objective of this study was to prospectively evaluate the short-term results of using the Ponseti technique for treatment of 418 children with clubfoot deformity, and to determine if the number of extensive corrective surgeries can be reduced in these children.

Consecutive cases were studied between July 1st - 2012 to July 31 - 2014 at Gauhati Medical College and Hospital, Guwahati. A total of 418 cases were studied. These included 277 male and 141 females, 227 bilateral, 191 unilateral (Right=119, Left=72) cases. Idiopathic clubfoot constituted 399 cases while 19 cases were syndromic. For casting, plaster of Paris (POP), bandage and cotton roll was used; for Tenotomy local anesthesia and 15 number surgical blades, and for maintenance of correction Steenbeek foot abduction brace was used for this procedure.

The Ponseti method is a safe and effective treatment for congenital Talipesequinovarus, and radically decreases the need for extensive corrective surgical procedures. With its low rate of complication, high effectiveness, low cost and need for minor surgery like a percutaneous Tenotomy of Achillestendon, Ponseti method has unmatched potential in developing countries like India.