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Study highlights outcomes of Ponseti method for untreated clubfeet in children
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According to recently published results, 95% of children with previously untreated clubfeet that underwent the Ponseti method achieved a plantigrade foot and this outcome was maintained by most patients. However, residual deformities were common after at least 10 years of follow-up.
“The [Hospital and Rehabilitation Center for Disabled Children] HRDC team achieved a plantigrade foot in the vast majority of patients with an untreated idiopathic clubfoot in patients from 1 [year] to 5 years of age using the Ponseti method and while residual deformities were common, patient-reported outcomes were satisfactory at 11 years follow-up,” study co-author David A. Spiegel, MD, told Healio.com/Orthopedics.
Researchers performed a retrospective review of medical records, which was followed up with an evaluation of physical findings and patient-reported outcomes using the Oxford Ankle Foot Questionnaire for Children. Investigators identified 145 patients with a total of 220 untreated idiopathic clubfeet. Patients were seen when they were between 1 year and 5 years old and treated with the Ponseti method. The minimum follow-up was 10 years. The average follow-up was 11 years, and the average patient age at treatment was 3 years. If the plantigrade foot was achieved without the need for soft-tissue release for osseous procedure, the treatment was considered successful.
Results showed the initial score based on the system of Pirani and colleagues averaged 7 and was 17 when based on the system of Diméglio and colleagues. Investigators noted that on average, eight casts were needed. In 96% of feet, surgical treatment was needed. A percutaneous Achilles tendon release was the most common procedure. In addition, 95% of feet achieved a plantigrade foot.
According to researchers, complete relapse was rare. However, residual deformities were common. Investigators noted there were “favorable” patient-reported outcomes. – by Monica Jaramillo
Disclosures: Banskota reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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