Malhotra Rohit, Mohapatra Ashutosh, Arora Geetika, Choudhury Priyam, Joshi Hitesh, Patel Pranav
Department of Orthopaedics, ESIC Model Hospital, Baddi 173205, Himachal Pradesh, India.
Department of Orthopaedics, Mohapatra Hospital, Ulhasnagar 421003, Maharashtra, India.
Children (Basel). 2018 Apr 10;5(4):49. doi: 10.3390/children5040049.
Congenital talipes equinovarus (CTEV), also known as clubfoot, is a complex congenital deformity of the foot that, left untreated, can limit a person's mobility by making it difficult and painful to walk. Worldwide, 80% of children born with clubfoot are in low- and middle-income countries. The management of clubfoot has a long history. Non-operative management did not become popular, as an increasing number of orthopaedists started leaning towards surgical treatment. The late Dr. Ignacio Ponseti developed a method of clubfoot correction that successfully realigns clubfoot in infants without extensive and major surgery. The aim of the study was to assess the functional outcome of CTEV management by the Ponseti technique, to study the severity of CTEV deformity using the Pirani score, and to evaluate the cost-effectiveness of the technique. A total of 356 cases with 402 feet with CTEV were treated by the Ponseti method. The average age of the children and the number of casts applied before full correction were 4.03 months and 6.91, respectively. There was a good functional outcome in 95.45% of cases (score > 30) at the last follow up. The management of CTEV by the Ponseti technique provides a good functional and cosmetic outcome. In a developing country like India, this technique is a safe, easy, economical method of clubfoot management.
先天性马蹄内翻足（CTEV），又称畸形足，是一种复杂的足部先天性畸形，若不治疗，会因行走困难和疼痛而限制患者的活动能力。在全球范围内，80%患有畸形足的儿童出生在低收入和中等收入国家。畸形足的治疗历史悠久。随着越来越多的骨科医生倾向于手术治疗，非手术治疗不再流行。已故的伊格纳西奥·庞塞蒂医生开发了一种畸形足矫正方法，该方法能在不进行广泛和大型手术的情况下成功使婴儿的畸形足重新归位。本研究的目的是评估庞塞蒂技术治疗CTEV的功能结果，使用皮拉尼评分研究CTEV畸形的严重程度，并评估该技术的成本效益。共有356例402只患有CTEV的足部采用庞塞蒂方法进行治疗。患儿的平均年龄以及完全矫正前应用石膏的次数分别为4.03个月和6.91次。在最后一次随访时，95.45%的病例（评分>30）获得了良好的功能结果。采用庞塞蒂技术治疗CTEV可提供良好的功能和美观效果。在像印度这样的发展中国家，该技术是一种安全、简便、经济的畸形足治疗方法。
