IJSR - International Journal of Scientific Research

Dr Hemeshwar Harshwardhan; Dr Poonam Gogania

Volume : VI, Issue : V, May - 2017

Evaluation of outcome in idiopathic clubfoot managed by Ponseti method

Dr Hemeshwar Harshwardhan, Dr Poonam Gogania

Abstract :

Introduction; Congenital talipes equinovarus, also known as clubfoot, is a relatively common skeletal deformity characterized by an excessively turned–in foot and a high medial longitudinal arch. Three different forms of this disorder have been identified; positional or postural, idiopathic, and teratogenic or syndromic. The etiopathogenesis of this anomaly is not clearly known. Two genes, PITX–1 and RBM–10, have recently been reported to play direct or indirect roles in the pathogenesis of clubfoot. Clinical diagnosis is at a glance; X–ray analysis is initially unnecessary but should be used after treatment to follow the outcome. Various surgical or nonsurgical methods of treatment have been applied to treat this disorder. Pirani et al has developed a reliable and valid method of clinically assessing the amount of deformity present in unoperated congenital clubfoot of less than 2 years of age. Material and method; The subject enrolled in the study were consecutive patients presenting with Idiopathic CTEV, attending Orthopedic OPD from December 2015 to December 2016. Results ; In total there were 30 children (44feet) presented with idiopathic deformity, treated by Ponseti technique, most of the children were below 6 week of age, when mobility of feet were analyzed with respect to different Pirani Score groups, it was also found that mean Pirani Score of supple and rigid feet were 3.19 and 5.42 respectively. The more severe the initial deformity, higher the Pirani Score, the more casts were required to obtain correction. Conclusion; The study clearly shows that, more severe the initial deformity, higher the Pirani Score, the more casts required to obtain correction. Age at initial presentation, quality (mobility) of foot and Pirani Score at presentation, has a direct beå on final results.