Early experience with the Ponseti method for the treatment of congenital idiopathic clubfoot.
BACKGROUND
The preferred conservative treatment for congenital idiopathic clubfoot deformity remains a controversial issue.


OBJECTIVE
To compare the outcomes of two groups of CICF patients who underwent two different treatment protocols.


METHODS
The study cohort included 72 infants treated in our hospital from August 1998 to December 2002. Group 1 comprised 40 infants (61 clubfeet) who were treated by a traditional method (a modification of the Kite and Lovell technique), and group 2 consisted of 32 infants (48 clubfeet) treated with the Ponseti technique. Both groups were similar in age, gender and severity of the deformity (Dimeglio scoring system).


RESULTS
After an average follow-up of 54.9 months (range 44-68), 35 (57%) clubfeet in group 1 required surgical intervention and 27 (44%) clubfeet had a residual deformity at last follow-up. In the Ponseti group, 45 (94%) clubfeet were fully corrected at last follow-up (average 29.2 months, range 16-45) while 3 (6%) clubfeet had residual deformity and required surgery. Achilles tendon tenotomy was performed with no complications in 47 clubfeet (in group 2) at an average age of 2.4 months (range 2-4 months).


CONCLUSIONS
Even after a relatively short follow-up period, our success rate with the Ponseti approach already appears to be significantly higher and to bear fewer complications than the traditional treatment, in agreement with the results published by other medical centers. We now endorse the Ponseti technique of conservative manipulative treatment for congenital idiopathic clubfoot in our department.
Segev
Eitan
E
Department of Pediatric Orthopedics, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. esegev@tasmc.health.gov.il
Keret
David
D
Lokiec
Franklin
F
Yavor
Ariella
A
Wientroub
Shlomo
S
Ezra
Elias
E
Hayek
Shlomo
S
D000125:Achilles Tendon / Q000601:surgery; D002370:Casts, Surgical; D003025:Clubfoot / Q000601:surgery / Q000628:therapy*; D015331:Cohort Studies; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008349:Manipulation, Orthopedic / Q000379:methods*; D019637:Orthopedic Procedures; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome