Background

Idiopathic clubfoot is the most frequent and difficult musculoskeletal congenital disability, affecting approximately one in every 750 babies. We intended to evaluate clubfoot defect outcomes using the Ponseti procedure because of its stated success rate of 93 percent. When compared to operational therapy, it is said to have a reduced complication rate, less discomfort, and improved functional outcomes at effected foot.

Methods

This analytical case series was conducted in Abbasi Shaheed Hospital, Karachi, Pakistan, from September 2021 to September 2022. The data were collected from medical records of patients by non-probability consecutive sampling techniques. Patients with CTEV defects were included. The various parameters of interest were included in questionnaire. The SPSS version 21 was used to analyze data.

Results

A total of 170 patients were registered with the CTEV history, the patient's age distribution was 1 year with a mean 5.21±2.3, median 5, and age range was 10 months, most patients were with 5 months of age (4.85 – 5.55 at 95% I). 137 patients were less than 6 months of age (80.6%), and 33 patients (19.4%) registered with a club foot. 78% of patients were males, while 22% of patients were females. Regarding club foot deformity, 110(64.7%) suffered unilateral CTEV, while 60 (35.3%) had bilateral CTEV. Achilles tenotomy was performed in 123 patients (72.4%). None of the variables were found significant in this study regarding tenotomy in CTEV patients, either unilateral or bilateral (p-value > 0.05) 

Conclusion

Achilles' tenotomy is typical in our setting when using the Ponseti manipulation and serial casting approach to treat patients with CTEV up to 8 months of age. Before beginning the Ponseti manipulation and serial casting for CTEV, it must be thoroughly addressed with the child's parents.

Keywords

Clubfoot, Ponseti, Achilles Tenotomy, Congenital, Talipes, Equinovarus