Outcome of the Ponseti Method for Treatment of Idiopathic Congenital Clubfoot.

Introduction Idiopathic congenital clubfoot is a complex deformity that requires treatment to reduce the deformity to a flexible, plantigrade, and painless foot. The Ponseti method has gained international prominence due to its effectiveness and reduction in the need for surgical procedures. The aim of this study is to determine the outcome of the Ponseti method in patients with idiopathic congenital clubfoot, which will generate local evidence. Methods A descriptive cross-sectional study was conducted in the Department of Orthopaedics at Jinnah Postgraduate Medical Centre (JPMC) Karachi over a six-month period, from September 6, 2022, to March 7, 2023. Participants were included if they were children under three years of age, presented with idiopathic congenital clubfoot, and had a Pirani score of 2 or higher. The outcome was assessed immediately after the completion of treatment and after four months by using the Pirani score. Results were graded as excellent (Pirani score <1), good (score 1-2), and poor (score >2). Baseline demographic characteristics and Pirani score were recorded immediately after completion of treatment and after four months. Effect modifiers such as age, gender, weight, residence, and baseline Pirani score were controlled through stratification. Post-stratification Chi-square test was applied taking p-value ≤0.05 as significant. Results Of 91 neonates, the mean age of the neonates was 1.44 ±0.66 years. There were 51 (56%) males and 40 (44%) females. The Pirani score immediately after the treatment was 1.61 ± 1.38. Excellent outcome immediately after the treatment was observed in 43 (47.3%), good in 26 (28.6%), and fair in 22 (24.2%). At four months follow-up, the Pirani score was 0.91 ± 0.81. Excellent outcome immediately after the treatment was observed in 63 (69.2%), good in 23 (25.3%), and fair in five (5.5%). Conclusion The Ponseti method is an effective and reliable treatment for idiopathic congenital clubfoot at a tertiary care hospital. The intervention achieves marked improvement in deformity correction and also sustains clinical benefits over the short-term follow-up period. Future research with extended follow-up periods and broader sample sizes is needed to further evaluate long-term functional outcomes.