Comparison of ponseti method versus surgical treatment in congenital idiopathic clubfoot: A 5-year follow up study

Abstract

Background: Congenital idiopathic clubfoot is a complex congenital deformity. The goal of treatment is to achieve pain-free plantigrade feet with good mobility and without deformity. Prior treatment for congenital idiopathic clubfoot included manipulation, serial casting, and major soft tissue release surgically by any of the following techniques: modified posteromedial release, complete subtalar release and posterior release. The objective of this study was to compare the functional outcome between Ponseti method and major surgical treatment. Materials and Methods: This prospective cohort study was conducted in congenital idiopathic clubfoot patients who underwent primary treatment by either Ponseti serial casting or major surgical soft tissue release between 2000 to 2012. Outcome measurements included the Functional Rating System of Laaveg and Ponseti, the talocalcaneal angle (TCA) in antero-posterior (AP) and lateral view radiographs.Results: Nineteen children (28 feet) were treated with Ponseti method and 19 children (30 feet) were treated with major surgery. The minimum follow up was 5.07 years (mean 5.94±1.01 years in the Ponseti group and 8.73±2.78 years in the surgical treatment group). In the last follow up, there was statically significant difference of the mean Functional Rating score between the Ponseti group and major surgery group. (95.35±2.31 and 89.76±4.97, p