title: Use of the Ponseti method in the Iranian population.
abstract: BACKGROUND
  The most common congenital orthopaedic condition requiring treatment is clubfoot. The Ponseti method, which has improved the recurrence rate, is at present the most attractive method of treatment in the north of America. The purpose of this study was to evaluate the outcome of this method in an Iranian population and look for characteristics that may affect the treatment process.
  
  
  METHODS
  A total of 78 patients (129 feet) were treated by precisely adhering to the technique originally introduced by Ponseti. Relapse was defined as any return of each of 4 clubfoot components according to the Dimeglio-Bensahel system. The mean follow-up period was 24.7 months and relapse was analyzed with respect to severity of primary disorder, number of casts, compliance with postcorrection bracing and stretching exercise, and educational level of parents.
  
  
  RESULTS
  At the end of the follow-up, 24 (18.6%) clubfeet experienced relapse as defined. The mean time to relapse was 13.7 months, 30 feet had brace noncompliance, and stretching was not done for 35 feet. Significant association was detected between recurrence and severity of clubfoot, number of casts for complete correction, and bracing and stretching exercise noncompliance.
  
  
  CONCLUSIONS
  The Ponseti method is a successful treatment protocol for idiopathic clubfoot. Its success rate will increase with use of abduction orthosis after complete correction and also by performing regular stretching exercises.
  
  
  METHODS
  Therapeutic level II.
authors.affiliation: Division of Orthopaedic, Department of Pediatric, Tehran University, Tehran, Iran.
authors.forename: Behnam
authors.initials: B
authors.lastname: Panjavi
authors.forename: Arash
authors.initials: A
authors.lastname: Sharafatvaziri
authors.forename: Ramin Haj
authors.initials: RH
authors.lastname: Zargarbashi
authors.forename: Saeed
authors.initials: S
authors.lastname: Mehrpour
mesh_terms: D001915:Braces; D002370:Casts, Surgical; D003025:Clubfoot / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007492:Iran; D008297:Male; D052580:Muscle Stretching Exercises / Q000379:methods; D010349:Patient Compliance; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome