An efficacy evaluation of Ponseti in the treatment of congenital clubfoot

LI Yu-quan; ZHONG Zhang-ning; LIAO Shi-jie; LU Rong-bin; ZHAO Jin-min; DING Xiao-fei

doi:10.3969/j.issn.2095-252X.2018.06.012

Abstract：Objective To evaluate the effects of Ponseti procedure on the congenital clubfoot at the infancy stage of life. Methods We collected 130 patients ( 192 feet ) with congenital clubfoot from October 2008 to January 2013. The age ranged 3 weeks-12 months. 108 patients ( 158 feet ) were followed up. According to the age, all patients were divided into 2 groups: younger infancy group ( ≤ 6 months ); older infancy group ( > 6 months, and ≤12 months ). All patients were treated by Ponseti. The results were evaluated by Diméglio scores. Results The mean follow-up was ( 5.37 ± 1.06 ) years ( range: 4 - 8 years ). The overall excellence rate was 92.41%. The excellence rate of the younger infancy group and the older infancy group were 92.59% and 92.31% respectively, showing no significant differences ( P > 0.05 ). Deformity reoccurred in 12 patients ( 4 patients in the younger infancy group, 8 patients in the older infancy group ) because they did not insist in wearing orthopedic shoes, showing no significant differences ( P >0.05 ). The number of casts used and the performance rate of percutaneous tendoachilles tenotomy were less and lower in the younger infancy group, showing significant differences ( P < 0.05 ). Conclusions Ponseti can obtain sactifactory effects in the treatment of congenital clubfoot deformity. If the children begin treatment in infancy, especially within the 6 months of birth, better outcomes can be achieved. The most common cause of relapse is the noncompliance of the bracing program.