A PROSPECTIVE STUDY OF TREATMENT OF IDIOPATHIC CLUBFOOT (CTEV) USING PONSETI METHOD
Authors: S. Loya Lavakumar. , G Prajwal. 
Published: June 2023

Background: Congenital talipes equina varus (CTEV) or clubfoot is one of the commonest orthopedic problems seen in infants. CTEV is the term used to describe as a deformity involving in utero malalignment of the calcaneo-talar-navicular complex of the foot. The incidence is 1 in 1000 live births with male to female ratio is 3:1 and is bilateral in 50% of the infants. Idiopathic congenital talipes equinovarus (clubfoot) is a complex deformity that is difcult to correct. The deformity has four components - cavus, adductus, varus equinus and internal tibial torsion. The goal of treatment is to reduce or eliminate these deformities so that the patient has a functional pain-free foot with good mobility and does not need to wear modied shoes. Most orthopaedic surgeons agree that the initial treatment should be non-surgical and should start as soon as possible after birth. Many methods have been described, most of which involve serial manipulation and casting. If left untreated, clubfoot inevitably leads to signicant long-term disability, deformity and pain. Although various surgical techniques are used to correct clubfoot, such as soft tissue releases or bony procedures in older children, currently, conservative management is the preferred option in infants. The technique of gradual and simultaneous correction of all deformities of CTEV using manipulation and casting at weekly interval described by Dr.Ignacio V. Ponseti has gained wide acceptance throughout the world. In this study, we have attempted to analyse the functional outcome of Idiopathic clubfoot using Ponseti's technique in children. To study the outcome following the use of Ponseti technique Objectives: for idiopathic clubfoot. To evaluate the efcacy of the Ponseti method in reducing extensive corrective surgery rates for congenital idiopathic clubfoot. Children with congenital Source Of Data: idiopathic clubfoot consulted at Basaweshwar teaching and general hospital; attached to Mahadevappa Rampure Medical College, Kalaburagi. Method Of Collection Of Data: The study proposes to include patients with congenital clubfoot examined according to the protocol. Associated deformities are noted.The severity of foot deformity was assessed according to Pirani scoring system before and after treatment.Serial toe to groin castings will be applied. The number of casts required to obtain correction and the need for tenotomy was also recorded. Patients will be reviewed at weekly intervals till all deformities except equinus are corrected and once in a month following tenotomy and the use of orthotics. Results: Average number of cast applied before equinus correction in 0-6month age group was 6.3 and 7-12month age group was 6.7 average number ofnal cast used in 0-6months of age was 7.3 and in 7-12months it was 7.7 .Average number of cast increases with increase in age and Pirani severity score 98% of patient had no residual deformity at the time of follow up 2% had relapse at the time of nal follow up. There was a signicant reduction in the PSS after each cast and these difference in PSS between before equinus correction and after the last cast were signicant with the p value of <0.001. Ponseti technique of treatment for Clubfoot deformity is very effective, a Interpretation / Conclusion: nd produces painless, mobile, exible, plantigrade and cosmetically acceptable foot without need of any major surgical intervention