Comparative Analysis of results between Conventional and Accelerated Ponseti Technique for idiopathic congenital clubfoot

Background: Ponseti method is a well-accepted treatment modality for children with clubfoot deformity. Accelerated frequency of cast changes in Ponseti method may limit the time spent is casts during the corrective phase of treatment without any effect on the final result. We conducted this study to compare the results of accelerated and the conventional Ponseti Method.

Method: A prospective experimental randomized controlled trial was conducted from July 2014 to June 2015. Forty cases with 53 clubfeet were taken up for the study. Half the cases were given biweekly plaster in the accelerated group and the other half weekly casts as per the conventional Ponseti method. All feet were scored using the Pirani method. Successful correction was labeled as Pirani Score <1. Failure was labeled as Pirani Score >1 even after 8 corrective casts. The ‘treatment time in plaster’ refers to the number of days in plaster prior to a tenotomy.

Results: There were no significant difference in the final Pirani score of the two groups. There were no episodes of recurrence at six months. The average duration of treatment in the accelerated group was 15 days whereas in the conventional method was 35 days.

Conclusion: The results of this study support accelerated frequency of cast changes in Ponseti technique. In developing countries where travelling to clinics necessitates time away from home, work, and family, the adoption of ‘accelerated casts’ can reduce the duration of treatment and perhaps help to improve compliance and overall outcomes.