title: The Effectiveness of the Ponseti Method for Treating Clubfoot Associated With Amniotic Band Syndrome.
abstract: BACKGROUND
  Amniotic band syndrome (ABS) is a congenital disorder with an associated incidence of clubfoot deformity in over 50% of patients. Although early reports in the literature demonstrated a poor response to casting treatments, recent application of the Ponseti technique in ABS patients have been more promising.
  
  
  METHODS
  A retrospective review of all patients with clubfoot and a concurrent diagnosis of ABS were reviewed at a single institution. Patients not managed initially with the Ponseti method were excluded. Data collected included patient age at presentation, sex, unilateral or bilateral, amniotic band location and associated findings, and response to treatment-number of casts and requirement of Achilles tenotomy, tibialis anterior tendon transfer, or other surgical procedures. Duration of treatment at latest follow-up visit was noted and outcome was based on clinical foot appearance and plan for any further procedures.
  
  
  RESULTS
  Twelve patients (7 female and 5 male) with a total of 21 feet (9 bilateral and 3 unilateral) were identified. The average age at presentation was 3 weeks (range, 1 to 9 wk). The average number of casts was 6 (range, 3 to 11). Seventeen of 21 feet (81.0%) underwent percutaneous Achilles tenotomy. The initial correction rate for all patients with the Ponseti technique was 20/21 feet (95.2%) and recurrence was noted in 7/21 feet (33.3%). One patient underwent primary posteromedial release and 2 patients had associated neurological deficits. The average follow-up was 3.9 years (range, 9 mo to 10 y) and all but one patient had supple, plantigrade feet.
  
  
  CONCLUSIONS
  The Ponseti technique is an effective first-line treatment in patients who have clubfeet associated with ABS, including those with a neurological deficit.
  
  
  METHODS
  Level IV.
authors.affiliation: *Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky ‡Shriners Hospital for Children, Lexington, KY †Baptist Pediatric Orthopaedics Center, Miami, FL.
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Carpiaux
authors.forename: Pooya
authors.initials: P
authors.lastname: Hosseinzadeh
authors.forename: Ryan D
authors.initials: RD
authors.lastname: Muchow
authors.forename: Henry J
authors.initials: HJ
authors.lastname: Iwinski
authors.forename: Janet L
authors.initials: JL
authors.lastname: Walker
authors.forename: Todd A
authors.initials: TA
authors.lastname: Milbrandt
mesh_terms: D000125:Achilles Tendon / Q000601:surgery; D000652:Amniotic Band Syndrome / Q000150:complications*; D002370:Casts, Surgical; D003025:Clubfoot / Q000150:complications* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008349:Manipulation, Orthopedic / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies; D013709:Tendon Transfer; D058971:Tenotomy; D016896:Treatment Outcome