Conservative management of idiopathic clubfoot: Kite versus Ponseti method.
OBJECTIVE
To compare the long-term results of the Kite and Ponseti methods of manipulation and casting for clubfoot.


METHODS
42 patients (with 64 idiopathic clubfeet) were equally randomised to Kite or Ponseti treatments in the early weeks of life. 14 males and 7 females (34 clubfeet) were treated by the Kite method, whereas 13 males and 8 females (30 clubfeet) were treated by the Ponseti method. All the clubfeet were manipulated, casted, and followed up (for a mean of 3 years) by one experienced orthopaedic surgeon. The final results were compared.


RESULTS
The success rates for the Kite and Ponseti treatments were similar (79% vs 87%). With the Ponseti method, the number of casts was significantly fewer (7 vs 10); the duration of casting required to achieve full correction was significantly shorter (10 vs 13 weeks); the maximum ankle dorsiflexion achieved was significantly greater (12 vs 6 degrees); and the incidence of residual deformity and recurrence was slightly lower.


CONCLUSIONS
The Ponseti method can achieve more rapid correction and ankle dorsiflexion with fewer casts, without weakening the Achilles tendon.
Sanghvi
A V
AV
Department of Orthopaedics, Government Medical College & New Civil Hospital, Surat, Gujarat, India. amishsanghvi@rediffmail.com
Mittal
V K
VK
D000843:Ankle Joint; D002370:Casts, Surgical; D002675:Child, Preschool; D003025:Clubfoot / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005684:Gait; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008349:Manipulation, Orthopedic / Q000379:methods*; D016059:Range of Motion, Articular; D016896:Treatment Outcome