Abstract
Aim: To evaluate our initial experience using the Ponseti method for the treatment of clubfoot.
Materials and Methods: 85 feet in 56 patients treated at Alder Hey Hospital, Liverpool between Nov 2002 – Dec 2004 were included in the study.
The standard protocol described by Ponseti was used for treatment.
Mean period of follow up was 12 months (6– 30 months).
Evaluation was by the Pirani club foot score.
Results: Results were evaluated in terms of the number of casts applied, the need for tenotomy and the recurrence of deformity.
Average number of casts required were 6.
Tenotomy was required in 80% of feet.
At the latest follow up approximately 15% of feet recurred following treatment and were managed surgically. Poor compliance was noted to be the main cause of failure in these patients. We have recently modified our splint and hope this will address some of the reasons for poor compliance. There was also a smaller subgroup of patients (approximately 5%) which failed to respond to the treatment regime and could not be brought to the point were tenotomy would be appropriate.
Conclusion: In our hands the ponseti technique has proved to be a very effective treatment method for the management of CTEV but like all treatment methods does have some limitations.
Correspondence should be addressed to the Honorary Secretary, BOFSS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
