title: Ponseti's manipulation in neglected clubfoot in children more than 7 years of age: a prospective evaluation of 25 feet with long-term follow-up.
abstract: We wanted to evaluate the efficacy of Ponseti's technique in neglected clubfoot in children more than 7 years of age. The results of Ponseti's method were evaluated in 21 children (25 feet) with neglected club feet. Patients were evaluated using the Dimeglio scoring system. All patients underwent percutaneous tenotomy of the Achilles tendon. The mean age at the time of treatment was 8.9 years. The mean follow-up period was 4.7 years. The average Dimeglio score at the start of the treatment was 14.2 compared with an average score of 0.95 at the end of the treatment at 1-year follow-up. Eighteen feet (85.7%) had full correction. Recurrence was seen in six feet (24%). At 4-year follow-up, the average Dimeglio score for 19 feet was 0.18. We recommend that Ponseti's method should be the preferred initial treatment modality for neglected clubfeet.
authors.affiliation: Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India. shahalamkhan@rediffmail.com
authors.forename: Shah Alam
authors.initials: SA
authors.lastname: Khan
authors.forename: Ashok
authors.initials: A
authors.lastname: Kumar
mesh_terms: D000125:Achilles Tendon / Q000601:surgery; D002370:Casts, Surgical; D002648:Child; D003025:Clubfoot / Q000145:classification / Q000503:physiopathology / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008349:Manipulation, Orthopedic; D009989:Orthotic Devices; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012775:Shoes; D016896:Treatment Outcome