Role of Ponseti Technique of Manipulation In Children with Idiopathic Club Foot Presenting After One Year Of Age. A Retrospective Study

Background: The Ponseti method of manipulation is accepted as a gold standard treatment for idiopathic clubfoot in infants. However, very few studies are available in literature on the use of this method in older children. The aim of this study is to determine the effectiveness of Ponseti manipulation technique in the treatment of late presenters of congenital idiopathic club foot deformity.

Material and Method: We retrospective evaluated the results of 23 children (15 males and 8 females) with 32 clubfeet deformity presenting after the walking age, which were treated with Ponseti manipulation. The outcome assessment was done by Pirani Score. Quantitative variables were expressed as mean ± standard deviation and compared between initial and last follow-up scores using the paired t-test.

Results: The mean age at presentation was 3.4 (range 1 to 15) years. The mean pre-correction total Pirani score was 4.51 (range 2.5 to 6) which improved to mean post-correction total Pirani score of 0.55 (range 0 to 1). This difference was statistically significant (p < 0.001). In 95% of the feet, satisfactory correction of the deformity was achieved. The mean number of casts applied was 9.2 (range 6 to 16). The mean follow-up duration was 14.2 (range 2 to 21) months.

Conclusion: We conclude that the Ponseti technique of manipulation is an effective method for the management of idiopathic clubfoot deformity in older children as well.