Comparative evaluation and analysis of outcomes in non-idiopathic and idiopathic clubfeet with Ponseti method at a tertiary care centre of a developing country |
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| Affiliation: | 1. Lecturer and Consultant Orthopaedic Surgeon, Department of Orthopaedic Surgery and Traumatology, Obafemi Awolowo University, Ile Ife, Nigeria;2. Professor and Head of Department of Orthopaedic Surgery and Traumatology, Obafemi Awolowo University, Ile Ife, Nigeria;3. Senior Lecturer and Consultant Radiologist, Department of Radiology, Obafemi Awolowo University, Ile Ife, Nigeria;1. Orthopedic Surgeon, Division of Orthopaedics, Hospital Universitari Sant Joan de Reus, Reus, Spain;2. Orthopedic Surgeon, Division of Orthopaedics, Hospital Universitari i Politecnic La Fe, Valencia, Spain;3. Researcher, Instituto Biomecánica de Valencia, Universitat Politècnica de València, València, Spain;4. Researcher, Grupo de Tecnología Sanitaria del IBV, CIBER de Bioingeniería, Biomateriales y Nanomedicina, Valencia, Spain;5. Radiologist, Division of Orthopaedics, Hospital Universitari i Politecnic La Fe, Valencia, Spain;6. Orthopedic Surgeon, Division of Paediatric Orthopaedics, Hospital Clínico Universitario de València, València, Spain;7. Orthopedic Surgeon, Instituto Biomecánica de Valencia, Universitat Politècnica de València, València, Spain;8. Orthopedic Surgeon, Grupo de Tecnología Sanitaria del IBV, CIBER de Bioingeniería, Biomateriales y Nanomedicina, Valencia, Spain |
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| Abstract: | BackgroundIdiopathic clubfoot (congenital talipes equinovarus, CTEV) is being managed worldwide by Ponseti method with high success rates, while for non-idiopathic clubfoot surgical interventions is being widely used with variable results. This study evaluated the effectiveness of Ponseti method in non-idiopathic clubfoot and compared the results with idiopathic clubfoot.MethodsThe paper evaluated the epidemiological incidence and demographic profile of non-idiopathic clubfoot in a tertiary centre of developing country. A total of 108 subjects with 85 having idiopathic (group I;125 feet) and 23 having non-idiopathic variety (group II;34 feet) were managed with Ponseti method and were followed for a mean duration of 38.33 (12–62) and 36.27 months (12–58) in group I and II respectively. The most common associations were meningomyelocele (MMC/spina bifida,5), arthrogryposis multiplex congenita (AMC,4), developmental dysplasia of hip (DDH,3) and Down’s syndrome and amniotic band syndrome (2 each).ResultsPrimary correction was achieved in both the groups in 98% and 87% in group I and II respectively, while recurrences of at least one deformity was observed in 11 (9%) and 12 (40%) feet in group I and II respectively. Favourable outcomes were noticed in 22 (65%) feet in non-idiopathic group and 12 feet (35%) underwent extensive soft tissue release as compared to 3 feet (2.4%) in idiopathic variety.ConclusionDeformities improved significantly in non-idiopathic clubfeet with Ponseti methods although complete correction was not possible. Extensive surgical interventions were reduced in up to 35% feet in non-idiopathic variety and hence, it is recommended as primary treatment for all variety of clubfeet, irrespective of their etiology. |
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| Keywords: | Congenital talipes equinovarus Idiopathic Non-idiopathic Ponseti method Favourable outcomes Recurrences Extensive soft tissue release |
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