Experience with accelerated ponseti technique for treatment of idiopathic clubfoot in a regional orthopaedic hospital in Nigeria.

INTRODUCTION

Idiopathic talipes equinovarus (ITEV) 'aka clubfoot' is the most common foot deformity in children. Ponseti technique had been accepted as a standard method for correction. The traditional Ponseti technique for correction is well known. Accelerated Ponseti technique is said to offer some advantages over the standard technique. The aim of this study was to determine and document the efficiency and success rate of accelerated Ponseti technique.

METHODS

This was a prospective interventional study which lasted 26 months from February 2017 to April 2019. Twenty-eight patients with 42 feets who met the inclusion criteria were recruited. They had serial manipulation and casting twice every week till percutaneous tenotomy was done as indicated. Final cast usually applied after tenotomy and left for 3weeks. Each patient was followed up for a year corresponding to 9 months after the commencement of night bracing. Data were analysed using SPSS version 20.

RESULTS

The mean age was 8.1 months with a range of 1-36 months. The mean Pirani score recorded was 4.4, while the mean number of casting sessions was 3.6 and the mean duration of treatment was 12.4 days. The tenotomy rate recorded was 42.9%. Pre-bracing assessment of Pirani score, passive ankle dorsiflexion and foot abduction done and repeated after a year revealed optimal correction. The relapsed rate at 1 year was 4.8%. The only complication observed was pressure sore in a patient.

CONCLUSION

The accelerated Ponseti technique is an efficient method of treatment of ITEV in a much shorter time with a higher success rate. It facilitates compliance with treatment.