Title: Abstracts Presented at the Annual Meeting of Indian Foot and Ankle Society (IFASCON 2019) at New Delhi, 2019
Abstract:Clubfoot has historically been treated by serial plaster castings (Kite's method) and by surgical methods (soft tissue releases).The recurrence of these procedures and stiff and painful foot in long t...Clubfoot has historically been treated by serial plaster castings (Kite's method) and by surgical methods (soft tissue releases).The recurrence of these procedures and stiff and painful foot in long term was common.Presently, Ponseti method is most accepted method for treating clubfoot worldwide.Literature shows that the immediate results are good, but has only few literature support for the long term results.This study evaluates the long term functional and cosmetic outcomes of Ponseti method in patients with idiopathic congenital clubfoot.Materials and methods: Thirty three feet (26 males and 7 females) treated by Ponseti method at our centre between January 2002 and December 2009 were included in this retrospective study.The details of history, Pirani Score, Laaveg-Ponseti functional score were collected. Results:The mean age at follow-up was 10.5 years (range 8-16 years) with male to female ratio being 3.7:1.In 85% of the patients, treatment was started within 2 months of age and in 3 patients after 4 months of age.The mean Pirani Score at the start of treatment, 5.35 ± 0.73, improved to a good extent 0.59 ± 0.48, which was statistically significant (p < 0.05).The mean Laaveg and Ponseti score was 89.06 ± 7.03, which came in the range of good to very good as per the scoring.Two children showed poor results probably due to lack of compliance with Foot Abduction Brace.There was no statistically significant association seen between Laaveg and Ponseti Grading and age at follow-up (p > 0.05) and with age at which treatment started (p > 0.05), showing that Laaveg-Ponseti grading is independent of the age of the patient and age at which the treatment started.Conclusion: Ponseti method, which consists of weekly serial manipulation, casting, tenotomy and use of foot abduction brace for minimum 4 years gives good cosmetic and functional results in idiopathic congenital clubfoot, which is shown by Pirani score and Laaveg-Ponseti score in the literature and in present study.Proper detailed explanation to the parents about the importance of casting andbracing, teaching them how to use the brace with strict follow-up increases the chances of good results in long term.Read More