A Review of Clinical Outcomes in Children with Clubfeet Treated with Ponseti method: A single-center study

Background of the Study: Clubfoot or Congenital Talipes Equinovarus (CTEV) is one of the most correctable congenital deformities which affects 1 in 1000 live births. It is more common in boys than girls with a ratio of 2.5:1 and 80% of children born with clubfoot worldwide belong to low to middle income countries. The Ponseti method is not only a detailed method of manipulation and casting but also of preventing and treating relapses and has now become the gold standard of care for the treatment of congenital clubfoot. Currently, few studies have been done in the Philippines to evaluate the state and outcome of clubfoot treatment in the country. With varying data as to its success rate and the factors associated with failures of treatment, the purpose of this study is to assess and evaluate local data in order to identify the effectiveness of Ponseti casting in our setting and find areas for improvement. 

Objective: This study aimed to determine the clinical outcomes of clubfeet treated with serial casting using the Ponseti method in our institution over a period of 3 years. 

Methodology: This was a retrospective study that investigated patients with congenital talipes equinovarus enrolled in Miracle Feet clinic at Ilocos Training and Regional Medical Center from January 2019 to December 2021. 

Results: A total of 21 patients with 29 clubfeet were included in this study of which all were of idiopathic type. The overall early success rate of Ponseti technique including manipulation, serial casting and tenotomy was 96.55 % for the correction of clubfoot deformity. The surgical rate was 3.45% in the form of posteromedial release of tendon. The complication rate was 3.45%. The tenotomy and bracing rates were noted to be 72.41% and 95.23% respectively.

Conclusion: This study provided more evidence of the high early success rate and low complication rate of the Ponseti treatment regime for clubfoot management in the local setting.

Keywords: Clubfoot, Congenital talipes equinovarus, Ponseti method, Pirani score