title: Management of idiopathic clubfoot by the Ponseti technique: our experience at a tertiary referral centre.
abstract: BACKGROUND
  Clubfoot or congenital talipes equinovarus is a common congenital abnormality of uncertain etiology. The purpose of this study was to assess the results of the Ponseti method in India and to investigate the demography of relapse and resistant cases.
  
  
  METHODS
  A total of 86 children (146 feet) below 1 year of age who had presented to the paediatric orthopedic outpatient department of our institution between June 2003 and January 2007 with unilateral or bilateral idiopathic clubfoot deformity were included in our study and treated conservatively by use of the Ponseti technique.
  
  
  RESULTS
  128 feet responded to the Ponseti casting technique initially and 18 feet were resistant to the conservative treatment. Of the responsive feet, for 20 feet there was a relapse of the deformity. Evaluation of the results showed that poor compliance with splintage was the most common cause of relapse; delayed presentation and atypical clubfeet resulted in high resistance to this technique. Correction achieved at our centre was 82.18%. This is less than in many recent studies and could be attributed to increased incidence of delayed presentation, poorer compliance, and atypical feet in our population.
  
  
  CONCLUSIONS
  We conclude that the Ponseti technique is recommended for management of clubfoot and strict compliance with splintage is essential to prevent relapses. People of lower socioeconomic status are at high risk of relapse and must be targeted to create awareness among them about the importance of compliance with splintage.
authors.affiliation: Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India.
authors.forename: Aditya Krishna
authors.initials: AK
authors.lastname: Mootha
authors.forename: Raghav
authors.initials: R
authors.lastname: Saini
authors.forename: Vibhu
authors.initials: V
authors.lastname: Krishnan
authors.forename: Kamal
authors.initials: K
authors.lastname: Bali
authors.forename: Vishal
authors.initials: V
authors.lastname: Kumar
authors.forename: Mandeep Singh
authors.initials: MS
authors.lastname: Dhillon
mesh_terms: D002370:Casts, Surgical; D002648:Child; D002675:Child, Preschool; D003025:Clubfoot / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011859:Radiography; D012017:Referral and Consultation; D012189:Retrospective Studies; D055502:Secondary Prevention; D058971:Tenotomy / Q000379:methods*; D016896:Treatment Outcome