Outcome of Ponseti Technique in Children with Congenital Talipes Equinovarus: A Quasi-Experimental Trial
DOI:
https://doi.org/10.36283//ziun-pjmd14-3/013Keywords:
ongenital talipes equinovarus, follow-up, Pirani score, Ponseti technique, tenotomyAbstract
Background: Idiopathic congenital talipes equinovarus (CTEV), also known as clubfoot, is a developmental disorder of the limb. This study was done to determine the outcomes of CTEV following the Ponseti technique in terms of change in Pirani score in children presenting at a tertiary care hospital of a developing country.
Methods: This quasi-experimental study was conducted in Jinnah Postgraduate Medical Center, Karachi, Pakistan, from 15th February 2023 to 30th December 2024. A total of 133 children aged 1 week to 2 years, having CTEV (Pirani score 3-6), and undergoing Ponseti treatment were analyzed. Non-probability consecutive sampling technique was employed. All children underwent corrective sequential castings with manipulation as per the Ponseti method. Patients were followed up for 12 weeks, and the Pirani score was assessed. Wilcoxon Rank test, Mann-Whitney U test, Kruskal-Wallis test, and bivariate correlational analysis were applied (as appropriate), taking p<0.05 as significant. Data analysis was performed using IBM-SPSS Statistics, version 26.0.
Results: In a total of 133 children, 101 (75.9%) were male. The median age was 2.00 (1.00-5.00) months. The median number of follow-up visits was 6.00 (6.00-8.00). Age distribution had having significant association with baseline Pirani score (p=0.002). The median baseline and final follow-up (12 weeks) Pirani score were 5.00 (4.00-6.00) and 0.50 (0.00-1.00), p<0.001. Post-treatment (at 12 weeks), the Pirani score was significantly higher among children who underwent percutaneous tenotomy (p<0.001). Relatively modest, but significant positive association of final Pirani score with number of follow-up visits (r=0.238, p=0.002).
Conclusion: The Ponseti technique is an effective and minimally invasive approach for managing CTEV in children, leading to significant improvement in Pirani scores over 12 weeks.
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