Effect of Ponseti Method in the Treatment of Congenital Talipes Equinovarus Combined with Imaging and the Risk Factors for Recurrence
ZHOU Diming
YUAN Xiafei
HAN Yahui
YU Xiaokun
YAN Dun
ZHAO Wei
ZHANG Jiao
Abstract：Objective To evaluate the curative effect of congenital talipes equinovarus(CTEV)in children treated by Ponseti method combined with imaging,and to explore the imaging and clinical factors related to the recurrence by multivariate logistic regression.Methods A total of 59 children(81 feet)with CTEV admitted to the First Affiliated Hospital of Zhengzhou University from January 2017 to December 2020 were retrospectively analyzed.Pirani score,Dimegilo score,anteroposterior calcaneal angle,first metatarsal angle of talus on anteroposterior view,lateral calcaneal angle,first metatarsal angle of talus on lateral view,tibio-talus angle on lateral view,first metatarsal angle of calcaneus on lateral view,and tibio-calcaneal angle on lateral view were compared before treatment and at the last follow-up.The children's gender,age of treatment,compliance with splints,number of casts,achilles tendon lengthening,and anteroposterior calcaneal angle,first metatarsal angle of talus on anteroposterior view,lateral calcaneal angle,first metatarsal angle of talus on lateral view,tibial talus angle on lateral view,first metatarsal angle of calcaneus on lateral view,and tibial calcaneal angle on lateral view at 3 months after treatment were investigated whether there is a correlation with recurrence.Results The average follow-up period was(4.33±1.10)years(range,2-6 years).The average number of casts required in 59 patients(81 feet)was(4.03±1.08)cases.Forty-seven cases(62 feet,75.54％)underwent achilles tendon lengthening,and 14 cases(19 feet,23.45％)had recurrence.According to Dimeglio classification,75 feet(92.6％)were grade Ⅰ and 6 feet(7.4％)were grade Ⅱ.At the last follow-up,Pirani score and Dimegilo score of the affected foot were lower than those before treatment(P＜0.001),and the anteroposterior talocalcaneal angle,the first metatarsal angle of the anteroposterior talus,the lateral talocalcaneal angle,and the first metatarsal angle of the lateral talus were higher than those before treatment(P＜0.001).The lateral tibiotalar angle,the first metatarsal angle of the lateral calcaneus,and the tibiotalcaneal angle of the lateral calcaneus were decreased(P＜0.001).The anteroposterior and lateral calcaneal angle,and brace compliance at 3 months after treatment were the risk factors for recurrence(P＜0.05).Conclusion Ponseti method can improve the morphological scores and imaging indexes of CTEV feet.The anteroposterior and lateral heel angle at 3 months after treatment and brace compliance are risk factors for recurrence of CTEV,which can provide reference for postoperative follow-up and treatment of CTEV.
Keywords：talipes equinovarusPonseti methodradiographic measurementlogistic regression
Publication Date：2025-03-13
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：5( 795-799 )