Abstract
This prospective study was designed to audit the introduction of this new technique for the treatment of club-feet in New Zealand. Although well proven in Iowa, USA the Ponseti Technique has rarely been practiced outside of this state.
Fifty feet in 32 consecutive patients have prospectively been followed since September 1999. All the patients have been treated by one surgeon in an identical fashion to that described by Dr Ponseti. The only difference was that the percutaneous tenotomies were preferentially performed under a general anaesthetic. Twenty four feet have had a detailed radiographic analysis as well. There have been 2 patients lost to follow-up. Twenty three patients were of Maori or Polynesian ethnicity. The pre treatment Pirani score averaged 5.0. The first cast was usually applied within 2 weeks of birth and the average number of casts was 6.0. The Achilles tendon tenotomy was not preformed in 4 feet. The mean follow-up Pirani score was 0.5. Four feet in 2 patients have required posteromedial release at 11 months of age. One patient has required a tibialis tendon transfer at 2 1/2 years of age. There have been minor skin complications from the boot wearing. The compliance with boot wearing is low with more than 50% of the patients wearing them less that 50% of the prescribed time.
The Ponseti Technique demands attention to detail if it is to be successful. These excellent early clinical and radiographic results support this method of treatment for idiopathic talipes equinovarus. Our concern is the long-term outcome in the patients with poor boot wearing compliance.
Correspondence should be addressed to the editorial secretary: Associate Professor Jean-Claude Theis, Department of Orthopaedic Surgery, Dunedin Hospital, Private Bag 1921, Dunedin, New Zealand.
