Original versus Accelerated Ponseti Techniques in Treatment of Congenital Talipes Equinovarus

Abstract

Background: Clubfoot, a prevalent congenital orthopedic anomaly, demands extensive treatment. Ignacio Ponseti introduced a non-invasive approach for its management.

Objective: This study aimed to compare the accelerated and traditional Ponseti therapy methods for congenital talipes equinovarus  (clubfoot).

Patients and Methods: Sixty infants diagnosed with idiopathic congenital talipes equinovarus were enrolled in an RCT. Patients  were divided into two groups, each comprising thirty individuals. One group underwent modified accelerated Ponseti therapy  with casts applied every three days, while the other followed the traditional Ponseti method with casts applied weekly. The severity of  clubfoot was assessed using the Pirani grading system, and the Ponseti procedure was employed for casting. Tendo-Achilles tendonitis  and tenotomy (TAT) were monitored, with a six-month follow-up period.

Results: The duration of treatment was significantly shorter in the modified accelerated group (Group II) compared to the traditional  group (Group I) (P<0.001). Group II exhibited greater improvement at six months and one-year posttenotomy compared to Group I.  Complication and recurrence rates were similar between the groups. The modified accelerated Ponseti method not only reduced  treatment duration but also facilitated in-hospital supervision, alleviating parental burden. Early identification of issues is possible with  this approach.

Conclusions: Besides expediting treatment, the modified method offers the advantage of hospital supervision, reducing  parental stress associated with frequent travel for plaster changes. Complication rates and recurrence were comparable between the two  methods.