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Journal articles on the topic 'Ponseti management'

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Author: Grafiati

Published: 10 December 2022

Last updated: 28 January 2023

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1

Sanghvi, AV, and VK Mittal. "Conservative Management of Idiopathic Clubfoot: Kite versus Ponseti Method." Journal of Orthopaedic Surgery 17, no. 1 (April 2009): 67–71. http://dx.doi.org/10.1177/230949900901700115.

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Purpose. To compare the long-term results of the Kite and Ponseti methods of manipulation and casting for clubfoot. Methods. 42 patients (with 64 idiopathic clubfeet) were equally randomised to Kite or Ponseti treatments in the early weeks of life. 14 males and 7 females (34 clubfeet) were treated by the Kite method, whereas 13 males and 8 females (30 clubfeet) were treated by the Ponseti method. All the clubfeet were manipulated, casted, and followed up (for a mean of 3 years) by one experienced orthopaedic surgeon. The final results were compared. Results. The success rates for the Kite and Ponseti treatments were similar (79% vs 87%). With the Ponseti method, the number of casts was significantly fewer (7 vs 10); the duration of casting required to achieve full correction was significantly shorter (10 vs 13 weeks); the maximum ankle dorsiflexion achieved was significantly greater (12 vs 6 degrees); and the incidence of residual deformity and recurrence was slightly lower. Conclusion. The Ponseti method can achieve more rapid correction and ankle dorsiflexion with fewer casts, without weakening the Achilles tendon.

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Nguyen, Julia, Jacob Veliky, Aedan Hanna, Jae Hoon Choi, Dhvani Shihora, Aleksandra McGrath, Neil Kaushal, Folorunsho Edobor-Osula, and Alice Chu. "The Impact of Treatment Method and Timing on the Long Term Outcomes of Pediatric Clubfoot Management." Foot & Ankle Orthopaedics 7, no. 4 (October 2022): 2473011421S0084. http://dx.doi.org/10.1177/2473011421s00848.

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Category: Other; Ankle; Hindfoot; Midfoot/Forefoot Introduction/Purpose: The Ponseti method of serial casting has been widely accepted as the new gold standard for management of idiopathic clubfoot, replacing joint invasive surgery, once the method-of-choice. While the short to midterm advantages of the method have been widely confirmed in the literature, there are limited comparative studies of the longer term outcomes. Dr. Ponseti's own definitive assessment of the long term result has not been decisively reevaluated by the literature. This systematic review compares the long-term functional outcomes of the two pediatric clubfoot management methods across different ages at treatment. Methods: A comprehensive search was conducted of PubMed, CINAHL, Web of Science, and Cochrane from inception to December 2020 to identify literature on clubfoot. Using PRISMA guidelines, the search terms clubfoot OR clubfeet OR clubbed foot OR clubbed feet OR talipes equinovarus were used. Articles containing more than three human subjects, were included. The database was searched for longitudinal studies of pediatric, idiopathic clubfoot management with the Ponseti method or joint invasive surgery. Retrospective studies of primary Ponseti treatment with serial casting or invasive soft tissue release and joint surgery that was performed on newly born and children up to twenty four months old and with reported mean follow-up of two years or longer were included. Evaluation reported according to different scoring systems were dichotomized as success (good to satisfactory results) or failure (residual or relapse that requires corrective management). Probability of less than 0.05 is considered statistically significant. Results: The initial search yielded 2907 articles, of which 29 articles reporting 2597 pediatric idiopathic clubfeet were included in this review, managed with either Ponseti casting, (group P = 1545 feet), or other surgical techniques, (group S = 1052 feet). The outcomes of 684 feet from group P with a mean long term follow up of 21+-13years were significantly superior to 1028 feet from group S with a mean follow up of 16+-5 years (p = 0.0002, odds ratio = 1.478). Multivariate analysis on 1310 feet from group P with mean age of 4.4 months (Range 1 - 8.9) against 794 feet from group S with mean age of 10.8 months (Range 1 - 22) detects no significant dependency on age (p = 0.128). Conclusion: The Ponseti method of serial casting resulted in significantly higher long term satisfaction outcomes compared with invasive surgical techniques in treatment of congenital clubfoot when performed within the first year of life. The findings supported Dr. Ponseti's own assessment regarding the high long term satisfaction rate (8+ years). Age was not found to be a significant contributor to the success of Ponseti casting over invasive surgery even though casting often started much earlier than surgery.

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Sharif, Shabana, Rehan Ramzan Khan, Saima Riaz, Sajid Rashid, Zaigham Rasool Athar, Tausif Aamir, and M. M. Khan. "Effectiveness of Ponseti Versus Kite Method for the Management of Club Foot- A Quasi Experimental Trial." Pakistan Journal of Medical and Health Sciences 15, no. 6 (June 30, 2021): 1871–73. http://dx.doi.org/10.53350/pjmhs211561871.

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Objective: To determine the effectiveness of ponseti versus kite method for the management of club foot among children. Methods: A quasi experimental trial was conducted to determine the most effective conservative method for managing idiopathic club foot. This study was carried out in District Head Quarter Hospital, Layyah. A total of 46 children (60 Feet) aged less than six months of both genders were included in this study using convenience sampling technique. The study sample was divided into Group A (Ponseti) and Group B (Kite). Each treatment group comprises of 30 feet. Patients were called for weekly follow up till ten weeks consecutively. At every follow-up visit, patients were assessed to check the improvement of deformity with the help of the Pirani scoring system for the foot. Pirani score difference was measured in both treatment groups from the baseline until the last follow-up interval until the 10th Week. Pirani score difference was measured in both treatment groups from the baseline until the last follow-up interval until the 10th Week. A greater negative value signified better correction. SPSS 23 was used for data entry and analysis. Results: Children's mean age in both treatment groups (A and B) was 10.83±4.59 and 10.20±4.75 weeks. At presentation mean Pirani score in both treatment groups (A and B) was 5.85±0.67 and 5.86±0.45, respectively, while at 10th follow up it was 1.42±0.39 and 2.35±0.54 for group A and group B, respectively. Conclusion: This study demonstrates that the Ponseti technique significantly improved the management of club foot as that of the Kites method. Ponseti's method is more effective in terms of rapid improvement in the involved group. Key words: Non operative Management, Idiopathic Club foot, Kites method, Ponseti method.

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Kuo, Ken N., and Peter A. Smith. "Evidence Favors Ponseti Management of Clubfoot." Journal of Bone and Joint Surgery 103, no. 21 (November 3, 2021): e87. http://dx.doi.org/10.2106/jbjs.21.00738.

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Venkata Shyam Prasad, Polisetty, and Lakshmi Sumana Voruganti. "MANAGEMENT OF CLUBFOOT BY PONSETI METHOD." Journal of Evolution of Medical and Dental Sciences 7, no. 12 (March 19, 2018): 1484–87. http://dx.doi.org/10.14260/jemds/2018/336.

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Mahajan, Neetin, Ujwal Ramteke, Sandeep Gavhale, Nikhil Palange, Akash Mane, and Harshit Dave. "Ponseti technique: efficacy in idiopathic clubfoot in Indian population." International Journal of Research in Orthopaedics 4, no. 4 (June 23, 2018): 614. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20182734.

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<p class="abstract"><strong>Background:</strong> The number of operations for clubfoot is many, but the results are not encouraging and more complications are encountered after operative treatment. Most surgeons believe manipulation to be easy; however they rarely complete the treatment and abandon it and go on to surgery. In the confusing scenario Ponseti Method evolved and proved across the world to be one of the most promising ways to correct club foot with low cost minimum surgery and good result in short period of time.</p><p class="abstract"><strong>Methods:</strong> 50 cases of idiopathic clubfeet (76 feet) were enrolled from a period of May 2006 to May 2008 in the department of Orthopaedic. Out of 50, 42 patients were followed-up for two years. Post tenotomy follow-up done every monthly for 3 months. At every visit babies were checked for any relapse and parents were counselled for the strict compliance with Foot Abduction Brace. The results of correction in 42 patients (64 feets) evaluated and compared with Ponseti's observation and other form of conservative management.<strong></strong></p><p class="abstract"><strong>Results:</strong> The analysis of results of correction of clubfeet deformity by Ponseti's method reveals around 95.30% of good to acceptable result as compared with Ponseti’s observation of around 99% which is comparable. We have observed 4.69% of poor result as compared with 1% observed by Ponseti.</p><p class="abstract"><strong>Conclusions:</strong> It is safe, efficient, Economical and most effective treatment for clubfoot which decreases the need for extensive corrective surgery. This technique can be used in children up to one year of age even after previous unsuccessful non-surgical treatment.</p>

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Scanlan, Emily, Kate Grima-Farrell, Emre IIhan, Paul Gibbons, and Kelly Gray. "Initiating Ponseti management in preterm infants with clubfoot at term age." Journal of Children's Orthopaedics 16, no. 2 (April 2022): 141–46. http://dx.doi.org/10.1177/18632521221080476.

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Purpose: Currently, the optimal time to initiate treatment among preterm infants with clubfoot is unknown. The aim of this study was to describe treatment outcomes up to 1 year post-correction following Ponseti management in infants who were born preterm but treated at term age. Methods: A retrospective chart audit was conducted at a major pediatric hospital on preterm infants with clubfoot who commenced Ponseti management at term age (≥37 weeks of gestation). Data are expressed as mean values (±standard deviation) or 95% confidence intervals (95% CIs). Results: Twenty-six participants (40 feet) born at 32.6/40 (±3.1) weeks of gestation were identified. Thirteen (50%) were male, 14 (54%) presented bilaterally, and 7 (27%) presented with syndromic clubfoot. Ponseti management was initiated at 41.4/40 (±2.8) weeks gestation. Baseline Pirani scores were 5.2 (95%CI: 4.8–5.6) in the idiopathic group and 5.7 (95%CI: 5.0–6.4) in the syndromic group. The number of casts to correction was 5.9 (95% CI: 5.1–6.6) for those with idiopathic clubfoot and 6.1 (95%CI: 5.0–7.3) for those with syndromic clubfoot. Achilles tenotomies were required in 13 (21 feet) with idiopathic clubfoot and five (7 feet) with syndromic clubfoot. Recurrence occurred in four infants (5 feet): 4 feet required further casting and bracing, and 1 foot required additional surgery. Conclusion: Ponseti management at term age in preterm-born infants yields comparable 1-year outcomes to term-born infants. Further research is required to determine whether outcomes beyond 1 year of age align with growth and development demonstrated by term-born infants who are managed with the Ponseti method. Level of evidence: Level IV.

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Blandinsky, V. F., M. A. Vavilov, T. E. Torno, and A. V. Donskoy. "MANAGEMENT OF ATYPICAL CLUBFOOT BY PONSETI METHOD." Traumatology and Orthopedics of Russia 16, no. 1 (May 12, 2010): 75–79. http://dx.doi.org/10.21823/2311-2905-2010-0-1-75-79.

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From May 2006 to August 2009 analyzed 28 clinical observations (34 feet) for children aged from 7 days to 1.5 years with severe atypical congenital clubfoot (Pirani 5,6 points), treated by the method of I. Ponseti. The average number of gypsum one foot to the full correction was - 6.3. It was written 38 achillotomy. Dates from the beginning of gypsum to achillotomy averaged - 34 days. All of the children undergoing treatment with us after the removal of plaster, dressed brace, fixing the foot fixed in position 45° abduction and 15° of flexion of the back and encouraged them to carry up to 3-4 years. All the children in this group achieved a complete correction of foot deformities without performing tenoligamentocapsulotomy. Results of treatment were evaluated according to the classification C. Pirani. Average score was 1.1 points. Follow-up was an average of 1 year 35 days.

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Charak, Sumeet Singh, Khalid Muzafar, and Omeshwar Singh. "Management of idiopathic clubfoot with Ponseti technique." International Journal of Research in Medical Sciences 5, no. 8 (July 26, 2017): 3355. http://dx.doi.org/10.18203/2320-6012.ijrms20173156.

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Background: Idiopathic congenital talipes equinovarus (club foot) is a complex deformity that is difficult to correct. The goal of treatment is to reduce or eliminate its four components so that the patient has a functional foot and leads a normal life.Methods: Study have treated 20 patients with 32 idiopathic clubfoot deformities using Ponseti method. The severity was assessed by modified pirani scoring.Results: The mean number of casts that were applied to obtain correction was 7.02 (range four to nine casts). Tenotomy was done in 30 feet. Thirty feet had good results. One patient developed recurrence of the deformity due to non-compliance of the use of orthrotics.Conclusions: The Ponseti method is a safe and effective treatment for congenital idiopathic clubfoot and radically decreases the need for corrective surgery. Non-compliance with orthotics main factor causing failure of the technique.

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Elgazzar, AmrS. "Ponseti management of clubfoot after walking age." Egyptian Orthopaedic Journal 49, no. 1 (2014): 29. http://dx.doi.org/10.4103/1110-1148.140535.

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Bor, Noam, John E. Herzenberg, and Steven L. Frick. "Ponseti Management of Clubfoot in Older Infants." Clinical Orthopaedics and Related Research 443, &NA; (March 2006): 224–28. http://dx.doi.org/10.1097/01.blo.0000201147.12292.6b.

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Yagmurlu, Mehmet Fırat, Mehmet Nurullah Ermis, Huseyin Emre Akdeniz, Erkin Kesin, and Eyup Selahattin Karakas. "Ponseti management of clubfoot after walking age." Pediatrics International 53, no. 1 (February 2011): 85–89. http://dx.doi.org/10.1111/j.1442-200x.2010.03201.x.

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Rahman, Mohammad Shahriar, Md Khorshed Alam, Md Shahiduzzaman, and Arebia Rahman. "Percutaneous needle tenotomy for Ponseti technique in the management of Congenital Talipes Equinovarus (CTEV)." Journal of Dhaka Medical College 23, no. 1 (March 26, 2015): 55–59. http://dx.doi.org/10.3329/jdmc.v23i1.22695.

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Background: The Ponseti method has become established treatment of choice in the management of clubfoot i.e. congenital talipes equinovarus (CTEV). Tenotomy of Tendo-achillis often is required as last step of ponseti method of treatment. This procedural note describes a simple method of doing a percutaneous tenotomy of Tendo-achilles. Methods: In Orthopedics OPD of Dhaka Medical College Hospital, Dhaka, percutaneous needle tenotomy was done in 70 feet of 52 patients from September 2013 to May 2014 by the same orthopedic surgeons for the management of CTEV by Ponseti technique. Results: We have found this technique is very effective than the commonly practiced percutaneous blade tenotomy or open tenotomy. Conclusion: This simple method of tenotomy using a wide bore needle during treatment of clubfoot in children can be a good surgical option. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22695 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 55-59

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Nguyen, Julia, Aedan Hanna, Jacob Veliky, Jae Hoon Choi, Dhvani Shihora, Aleksandra McGrath, Neil Kaushal, Folorunsho Edobor-Osula, and Alice Chu. "Prospects of Long Term Relapse after Management of Pediatric Clubfoot with the Ponseti Method: A Systematic Review." Foot & Ankle Orthopaedics 7, no. 4 (October 2022): 2473011421S0084. http://dx.doi.org/10.1177/2473011421s00847.

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Category: Other; Ankle; Hindfoot; Midfoot/Forefoot Introduction/Purpose: The Ponseti method of serial casting has been recognized as the gold standard for management of idiopathic clubfoot, a very common congenital foot deformity. While the short to midterm success of the method has been widely confirmed in the literature, there are very limited published studies of the longer term trend of relapse. Dr. Ponseti's own definitive assessment of the long term result has not been decisively reevaluated by the literature. This systematic review examines the long-term functional outcomes and evaluates the relapse rates of the Ponseti method. Methods: A comprehensive search was conducted of PubMed, CINAHL, Web of Science, and Cochrane from inception to December 2020 to identify literature on clubfoot. Using PRISMA guidelines, the search terms clubfoot OR clubfeet OR clubbed foot OR clubbed feet OR talipes equinovarus were used. Articles containing more than three human subjects, were included. The database was searched for longitudinal studies of pediatric, idiopathic clubfoot management with the Ponseti method. Retrospective studies of primary Ponseti management performed on neonates and children up to twenty four months old and with reported mean follow-up of two years or longer were included. Evaluation reported according to different scoring systems based on clinical examination of foot function, radiographic studies, or patient satisfaction questionnaires were dichotomized as success (good to satisfactory results) or failure (residual or relapse that requires corrective management or surgery). Probability of less than 0.05 is considered statistically significant. Results: The search yielded 20 articles following 2782 treated idiopathic clubfeet for 6.4 (2.6 - 19) years. The rate of successful initial correction was 97% (86.6% - 100%), satisfactory functional outcomes at last follow-up was 90% (63.4% - 100%), relapse was 21% (5.3% - 68%), and surgery needed to correct relapse was 9% (2.5% - 24%). Functional outcomes were inversely correlated with follow-up to 9 years (R= -0.5300, p= 0.0173), then became insignificantly associated when following up to 19 years (R= - 0.2480, p= 0.1458). Relapse rate was strongly correlated with follow-up to 9 years (R= 0.5540, p= 0.0129), then subsided thereafter to 19 years (R= 0.3792, p= 0.0495). The frequency of surgical release correlated with follow-up in a similar pattern, strongly up to 9 years (R= 0.6204, p= 0.0052), subsiding thereafter to 19 years (R= 0.3142, p= 0.0887). Conclusion: The short-term trends were consistent with literature findings that the rate of relapse increased during the first ten years, leading to lower patient satisfaction and higher rate of surgical correction. However, our new findings of weak long-term correlation and declining deformity relapse after nine years supported Dr. Ponseti's own assessment that late relapses were exceptions. The trend was consistent with uncommon returning relapses after a secondary corrective management or surgery. This trend also supports the postulation that the cause of relapse was non-compliance with foot abduction bracing, rather than clinicians' learning curves, age at presentation, or deformity severity.

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Nagaraj, Sreeranga, Shankara K, and Lakshmeesha T. "Management of congenital talipes equino varus by ponseti method: Our experience." Asian Pacific Journal of Health Sciences 1, no. 4 (October 2014): 471–78. http://dx.doi.org/10.21276/apjhs.2014.1.4.28.

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Newaz, Md Mehedi, Avijit Kumar Sikder, and Faruquzzaman. "Comparison of the outcome of management of congenital idiopathic clubfoot treated by ponseti method with modified technique." Bangladesh Medical Journal Khulna 52, no. 1-2 (March 26, 2020): 7–11. http://dx.doi.org/10.3329/bmjk.v52i1-2.46141.

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Background: Ponseti's technique has become the standard and most effective treatment modality for correction of Congenital Talipes Equinovarus (CTEV) in newborn. With time, little modification has been done in the classic technique. Objective: Our objective in this study was to compare the outcome in the recent years (modified Ponseti technique) with the results of our previous study (classic Ponseti technique). Methods: A total number of 976 patients (1553 feet) of Congenital Talipes Equino Varus were treated from October 2009 to February 2019 in Khulna Medical College Hospital and in private hospitals. In this retrospective study (based on convenient sampling), there were two groups. In group A, a total 621 patients (with a total 1033 feet) were treated from October 2009 to August, 2015. In group B, 355 patients (520 feet) were treated from November 2015 to February 2019. Results: In this study, in group A, approximately 88.6% was in 0-6 months age group. 64.9% was male patients. 3.7% patients had positive family history. In group B, majority of the patients (301, 84.8%) was in 0-6 months age group. 211 patients (59.4%) was male child. In approximately 3.1% (11) patients family history was positive. Approximately in 95.9% (991 out of total 1033) and 96.5% (502 out of total 520) feet respectively in group A and B, tenotomy was required. Dropout rates were 7.6% and 4.1% in respective groups. Minor bleeding was observed in approximately 1.5% (15) and 1.4% (7) feet in respective groups, followed by plaster related complications in approximately 2.2% (23) and 1.0% (5) feet in group A and B. Patients' compliance was found significantly higher in group B in contrast to group A. In group B, it was over 90%, whereas in group A, it was approximately 64.1 %. Conclusion: The ultimate outcome of Ponseti repair is improving by less requirement of total number of plaster, resistant cases and reduction in overall dropout rate by the newer modification. Bang Med J (Khulna) 2019; 52 : 7-11

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Chauhan, Dr Kaustubh M., Dr Gaurav M. Meda, Dr Gaurang M. Patel, and Dr Hemant H. Mathur. "Early results of clubfoot management by ponseti method." International Journal of Orthopaedics Sciences 3, no. 3g (July 1, 2017): 460–63. http://dx.doi.org/10.22271/ortho.2017.v3.i3g.77.

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Zuber, Mohammad, Ishrat Jahan, and Sanjeev Kumar. "MANAGEMENT OF CONGENITAL TALIPES EQUINOVARUS BY PONSETI METHOD." Journal of Evolution of Medical and Dental Sciences 3, no. 53 (October 15, 2014): 12344–57. http://dx.doi.org/10.14260/jemds/2014/3631.

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Mehtani, Anil, Jatin Prakash, Vipul Vijay, Nishikant Kumar, and Abhinav Sinha. "Modified Ponseti technique for management of neglected clubfeet." Journal of Pediatric Orthopaedics B 27, no. 1 (January 2018): 61–66. http://dx.doi.org/10.1097/bpb.0000000000000450.

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Hassan, Mohamed Khaled, Abdelkhalek Hafez Ibrahim, Maged Mohamed Mostafa, and Hatem Abdelmoneim Bakr. "Ponseti method for management of neglected idiopathic clubfoot." Current Orthopaedic Practice 24, no. 3 (2013): 295–97. http://dx.doi.org/10.1097/bco.0b013e31828ab8b2.

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Narasimhan, Ramani, and Paras Bhat. "Modified Ponseti technique of management of idiopathic clubfoot." Apollo Medicine 8, no. 4 (December 2011): 281–86. http://dx.doi.org/10.1016/s0976-0016(11)60007-0.

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Evans, Angela M., and Do Van Thanh. "A Review of the Ponseti Method and Development of an Infant Clubfoot Program in Vietnam." Journal of the American Podiatric Medical Association 99, no. 4 (July 1, 2009): 306–16. http://dx.doi.org/10.7547/0980306.

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Background: The Feet for Walking clubfoot project from Australia formally introduced the Ponseti technique in Vietnam in 2004 and is based at the Da Nang Orthopedic and Rehabilitation Centre in central Vietnam. Methods: We provide an initial overview of the management of infant clubfoot deformity using the nonsurgical Ponseti method. Results: Early indicators of the outcome of implementing this clubfoot project are largely positive but also require ongoing review. Further analyses of the use of the Ponseti method (or obstacles preventing the same) following training of personnel is underway. Conclusions: Recent research has improved and refined the technique that must now be both appreciated and incorporated by clinicians. This technique is used across the world in both developed and developing countries and is universally regarded as the best management method for clubfoot deformities. (J Am Podiatr Med Assoc 99(4): 306–316, 2009)

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Choudhary, Ranjeet, Alok Chandra Agrawal, Anupam Pradip Inamdar, Pandya Raj, and Shilp Verma. "Bilateral idiopathic club foot in baby of a rheumatoid mother: A rare case report and its management." IP International Journal of Orthopaedic Rheumatology 7, no. 1 (August 15, 2021): 46–49. http://dx.doi.org/10.18231/j.ijor.2021.011.

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Congenital clubfoot has a multifaceted etiology, with several hypotheses offered in its etiopathogenesis. The clubfoot has rarely been reported in babies born to women who have rheumatoid arthritis (RA). We present a rare case of a 31-year-old lady with RA on disease-modifying anti-rheumatoid drugs who delivered a child with bilateral congenital clubfoot. She had previously been using Methotrexate, Hydroxychloroquine, and Sulfasalazine regularly, but Methotrexate was stopped seven months before pregnancy. A full-term female baby was born through the cesarean section with bilateral clubfoot deformity and a modified Pirani score of eight out of 10. The deformity correction was done with the Ponseti serial casting method. The final modified Pirani score was two out of ten. In newborns born to rheumatoid arthritis mothers, the club foot deformity was effectively treated with serial Ponseti corrective casts, as was idiopathic clubfoot in babies born to non-rheumatoid mothers. Our findings validate the Ponseti serial casting method for these kinds of patients.

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Girotra, Prateek, K. Prashanth Kumar, and Rejo Varghese Jacob. "Evaluation of effectiveness of Ponseti's method in the clubfoot management under 1-year children: a prospective study." International Journal of Research in Orthopaedics 7, no. 2 (February 23, 2021): 228. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20210042.

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<p class="abstract"><strong>Background:</strong> Congenital talipes equino Varus is common congenital orthopedic foot deformity in children characterized by hindfootequinus, hind foot varus, midfoot cavus, and forefoot adduction deformities. There is a necessity to analyze the number of casts employed in the treatment, compliance of bracing, relapse pattern and percentages of surgical referral under 1 year of age for clear understanding and better practice to achieve successful outcomes. This study aimed to judge the effectiveness of Ponseti in the treatment of clubfoot under 1-year old children. </p><p class="abstract"><strong>Methods:</strong> The patients were selected in the OPD and evaluated for virgin idiopathic clubfoot under 1-year age. Serial casting done weekly by Ponseti method after assessing Pirani and Demeglio score before every cast.</p><p class="abstract"><strong>Results:</strong> In our study all 29 clubfeet that were treated by Ponseti method showed complete correction. Minimum cast being 5 and maximum being 10 casts. Corrected feet were supple, plantigrade and painless of which 1 foot had relapse<3weeks due to ill-fitting shoes. Which was subsequently corrected with repeat tenotomy and cast application.</p><p class="abstract"><strong>Conclusions:</strong> The Ponseti method is a safe, effective, cheap and reproducible method for correction of CTEV which significantly reduces the rate of extensive corrective surgeries for correction of clubfoot under 1-year age. For successful outcome and to prevent relapse, this technique must be applied strictly in accordance to the protocol and parents must be taught the importance of full compliance with bracing. Our series has a short follow up. Longer follow-up is needed for further evaluation of effectiveness of Ponseti method. </p>

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Rijal, R., B. P. Shrestha, G. P. Khanal, P. Chaudhary, R. Maharjan, S. R. Paneru, and P. Rai. "Transfer of technology regarding correction of congenital talipesequinovarus by ponseti method of treatment to doctors working at peripheral hospitals of eastern region of Nepal covered by BPKIHS, Dharan." Health Renaissance 13, no. 2 (June 20, 2017): 144–52. http://dx.doi.org/10.3126/hren.v13i2.17564.

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Background: Ponseti method of manipulation and casting has been standard non operative method of treatment for idiopathic clubfoot. We have conducted this study to find out whether Ponseti method of correction can be taught to doctors working at district hospital.Objective: To assess the knowledge, familiarize the Ponseti method of correction and to decrease the need of surgery regarding the congenital talipesequinovarus.Method: We conducted prospective study among doctors working in the district hospitals of eastern Nepal. We assessed knowledge and practice regarding clubfoot management before and after the intervention by questionnaire based method. The data were analyzed using before and after difference for magnitude and paired t test for significance.Result: 13 doctors were included in the study. Among 13 participants, one (7.69%) had formal orthopedic training. Only 30% of the participants had more than 60% correct response regarding questionnaires regarding knowledge of clubfoot. 40% of participants had done referral of cases to orthopedic centre. One (7.69%) of the participants had applied Ponseti cast. 61% percent of the participants responded more than 60% correctly at the final follow up at one year.Conclusion: The study shows that the knowledge and practice regarding Clubfoot correction is inadequate and hence teaching of Ponseti method was useful in the district hospital.Health Renaissance 2015;13(2): 144-152

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Docker, Charles EJ, Simon Lewthwaite, and Nigel T. Kiely. "Ponseti Treatment in the Management of Clubfoot Deformity – A Continuing Role for Paediatric Orthopaedic Services in Secondary Care Centres." Annals of The Royal College of Surgeons of England 89, no. 5 (July 2007): 510–12. http://dx.doi.org/10.1308/003588407x187739.

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INTRODUCTION The Ponseti technique is a well-proven way of managing paediatric clubfoot deformity. We describe a management set-up which spreads the care between secondary and tertiary care with no loss of quality. PATIENTS AND METHODS In our audit of the first 2 years of Ponseti casting in the treatment of idiopathic congenital talipes equinovarus (CTEV, clubfoot) deformity, we identified 77 feet having been treated in 50 patients. Forty-nine feet were treated primarily in Oswestry, a tertiary referral centre for paediatric orthopaedic conditions, and 13 feet were treated in conjunction with the physiotherapy department at one of the region's district general hospitals (Leighton Hospital, Crewe, Cheshire). RESULTS Similar good results and low requirement for surgical interventions other than Achilles tenotomy, which forms part of the Ponseti regimen, were found in both cohorts. CONCLUSIONS This ‘hub-and-spoke’ approach would appear to be efficient in terms of resource utilisation. Additional benefits atients and their carers include ease of access to services and reduced financial and transport burdens.

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Youn, Sean B., Ashish S. Ranade, Anil Agarwal, and Mohan V. Belthur. "Common Errors in the Management of Idiopathic Clubfeet Using the Ponseti Method: A Review of the Literature." Children 10, no. 1 (January 12, 2023): 152. http://dx.doi.org/10.3390/children10010152.

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Congenital talipes equinovarus is one of the most prevalent birth defects, affecting approximately 0.6 to 1.5 children per 1000 live births. Currently, the Ponseti method is the gold-standard treatment for idiopathic clubfeet, with good results reported globally. This literature review focuses on common errors encountered during different stages of the management of idiopathic clubfeet, namely diagnosis, manipulation, serial casting, Achilles tenotomy, and bracing. The purpose is to update clinicians and provide broad guidelines that can be followed to avoid and manage these errors to optimize short- and long-term outcomes of treatment of idiopathic clubfeet using the Ponseti method. A literature search was performed using the following keywords: “Idiopathic Clubfoot” (All Fields) AND “Management” OR “Outcomes” (All Fields). Databases searched included PubMed, EMBASE, Cochrane Library, Google Scholar, and SCOPUS (age range: 0–12 months). A full-text review of these articles was then performed looking for “complications” or “errors” reported during the treatment process. A total of 61 articles were included in the final review: 28 from PubMed, 8 from EMBASE, 17 from Google Scholar, 2 from Cochrane Library, and 6 from SCOPUS. We then grouped the errors encountered during the treatment process under the different stages of the treatment protocol (diagnosis, manipulation and casting, tenotomy, and bracing) to facilitate discussion and highlight solutions. While the Ponseti method is currently the gold standard in clubfoot treatment, its precise and intensive nature can present clinicians, health care providers, and patients with potential problems if proper diligence and attention to detail is lacking. The purpose of this paper is to highlight common mistakes made throughout the Ponseti treatment protocol from diagnosis to bracing to optimize care for these patients.

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Wooly, Sameer, and Anand B. S. Kumar. "Management of Idiopathic Clubfoot By Ponseti Method-Our Experience." Indian Journal of Orthopaedics Surgery 2, no. 1 (2016): 83. http://dx.doi.org/10.5958/2395-1362.2016.00013.x.

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Duffy, Catherine M., Jose J. Salazar, Lee Humphreys, and Brona C. McDowell. "Surgical Versus Ponseti Approach for the Management of CTEV." Journal of Pediatric Orthopaedics 33, no. 3 (2013): 326–32. http://dx.doi.org/10.1097/bpo.0b013e31827d0b2c.

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Jowett, C. R., J. A. Morcuende, and M. Ramachandran. "Management of congenital talipes equinovarus using the Ponseti method." Journal of Bone and Joint Surgery. British volume 93-B, no. 9 (September 2011): 1160–64. http://dx.doi.org/10.1302/0301-620x.93b9.26947.

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Barik, Sitanshu, Muhammed Nazeer, and Babloo Thomas Mani. "Accelerated Ponseti technique: efficacy in the management of CTEV." European Journal of Orthopaedic Surgery & Traumatology 29, no. 4 (December 6, 2018): 919–24. http://dx.doi.org/10.1007/s00590-018-2353-1.

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Natesan, Dr R., Dr A. Senthilnathan, Dr R. Prabakhar, and Dr R. Anand Kumar. "Management of idiopathic clubfoot by ponseti method: Prospective study." International Journal of Orthopaedics Sciences 8, no. 4 (October 1, 2022): 113–18. http://dx.doi.org/10.22271/ortho.2022.v8.i4b.3249.

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Bakhsh, Wahid, Pervez Ali, Asad Ullah Jan, Muhammad Shafiq, Malik Naveed Iqbal, and Naveed Gul. "Ponseti Method in the Management of Clubfoot under the 4 Years of Age." Pakistan Journal of Medical and Health Sciences 16, no. 5 (May 30, 2022): 1334–37. http://dx.doi.org/10.53350/pjmhs221651334.

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Background: The number of children born in the United States with a congenital clubfoot rises steadily each year. As per the Centers for Disease Control and Prevention, CTEV is spread once every 1,000 births. The vast majority of those infants are born in countries where they are mistreated or get insufficient care, resulting in a decrease in their overall life quality. CTEV has managed and been familiar to humanity since the dawn of time, and its surrounding disputes have existed similarly. Numerous studies have contributed to our understanding of patho-anatomy and therapy accountability for various illnesses. This study looked at how well a CTEV cast repair worked after a series of Ponseti cast repairs. Objective: Patients with a history of congenital talipesequinovarus who underwent serial cast repair using the Ponseti procedure were the focus of the study. Study Setting: Teaching Hospital Kech ;Turbat Pakistan Methods: The Ponseti method was used to treat 60 children between June 2017 and December 2019. A 1.5–2 year follow-up was undertaken in this study. Utilizing the goniometry and Pirani score, the researchers evaluated the deformity before and after therapy. Data was analysed with the SPSS programme. An average of five castings were necessary before the entire project could be completed. 85% of the feet were cast for a total of seven weeks of wear. Ninety-four patients (33%), requiring tenotomies, had a fully repaired achilles tendon. Pirani and goniometry scores differed significantly between the pre- and post-treatment periods. According to the optimistic prognosis, there were 66 cases of clubfoot, or 90.4%. For a moderate prognosis, the number was four, or 5.4%. In the event of a poor prognosis, the number of deformities was three, which corresponds to 4.1%. Conclusion: Regarding addressing clubfoot deformity, the Ponseti manipulation approach is effective, and plaster casting is also quite effective. It is fundamental in underdeveloped nations, and well-trained doctors and other healthcare professionals can successfully supervise cases through the use of casts and other control measures.

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Saif Ullah, Md, Kazi Md Noor-ul Ferdous, Md Shahjahan, and Sk Abu Sayed. "Management of Congenital Talipes Equino Varus (CTEV) by Ponseti Casting Technique in Neonates: Our Experience." Journal of Neonatal Surgery 2, no. 2 (March 28, 2013): 17. http://dx.doi.org/10.47338/jns.v2.29.

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Objective: The purpose of this study is to evaluate the results of Ponseti technique in the management of congenital Talipes Equino Varus (CTEV) in neonatal age group.Methods: It is a prospective observational study, conducted during the period of July 2010 to December 2011 at the Department of Pediatric Surgery in a tertiary hospital. All the neonates with CTEV were treated with Ponseti casting technique. Neonates with other congenital deformities, arthrogryposis and myelomeningocele were excluded.Results: Total 58 CTEV feet of 38 neonates were treated. Twenty six were males and 12 were females. Thirty seven (63.8%) feet were of rigid variety and 21(36.2 %) feet were of non-rigid variety. Twenty patients had bilateral and 18 had unilateral involvement. Mean pre-treatment Pirani score of study group was 5.57. Mean number of plaster casts required per CTEV was 3.75 (range: 2-6). Thirty five rigid and 15 non-rigid (total 86.2%) feet required percutaneous tenotomy. Out of 58 feet 56 (96.6%) were managed successfully. Three (5.2%) patients developed complications like skin excoriation and blister formation. Mean post-treatment Pirani score of the study group was: 0.36 ± 0.43.Conclusion: The Ponseti technique is an excellent, simple, effective, minimally invasive, and inexpensive procedure for the treatment CTEV deformity. Ideally it can be performed as a day case procedure without general anesthesia even in neonatal period.

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Matar, HE, and NK Garg. "Management of joint dislocations of the lower limb in Larsen syndrome: practical approach." Annals of The Royal College of Surgeons of England 99, no. 1 (January 2017): e8-e10. http://dx.doi.org/10.1308/rcsann.2016.0258.

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INTRODUCTION Larsen syndrome is an autosomal-dominant osteochondrodysplasia characterised by large joint dislocations and craniofacial anomalies. CASE HISTORY We present a rare case of Larsen syndrome with bilateral dislocated hips and knees and severe clubfeet at 7-year follow-up. We undertook bilateral open reduction of both hips at age 8 months. This procedure was preceded by open reduction and left-knee V–Y quadricepsplasty at age 4 months following a failed trial of closed reduction of the left knee. Both feet had a severe deformity (Pirani score of 5.5 and 6.0) and were treated using the Ponseti method, but the left foot relapsed at 24 months and required posteromedial release. CONCLUSIONS We tried to address the difficult questions on the timing and sequence of surgical interventions by treating clubfeet and dislocated knees early using Ponseti casts which included the knees. Open reduction of hips was done later, and further interventions were guided by functional needs.

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Newaz, Md Mehedi, and Avijit Kumar Sikder. "Outcome of management of congenital idiopathic clubfoot by ponseti technique." Bangladesh Medical Journal Khulna 48, no. 1-2 (March 25, 2016): 11–15. http://dx.doi.org/10.3329/bmjk.v48i1-2.27091.

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The congenital idiopathic clubfoot (CICF) is one of the most common serious birth defect of human bones and joints. Deformity leads to downward spiral of disability, dependency and demoralization. The Ponseti technique has become the standard for treatment of congenital clubfoot in the last 2 decades and a triumph in the very complex field of management of congenital idiopathic clubfoot. In this clinical study, our main aim is to evaluate necessity of the Ponseti treatment protocol in a timely, safe, effective & sustainable manner. In this clinical trial, 621 patients (with a total 1033 feet) of 00 (from birth) to 36 months of age were selected as the study population since October, 2009. Most of them were male children (71.3%) and majority were in >03-06 months of age group. In most of the patients (about 92%), only 05 serial plasters were found to be effective & quite sufficient, whereas, only in 5.3% patients, 06-07 plasters were required followed by 1.7% patients requiring more than 07 plasters. In this study, 06 resistant cases were found where correction was relatively slower than others, but no case of treatment failure was identified. The Mid foot score (MS) found to fall greatly in plaster phases and at the end of 5h plaster it was significantly lower (0.2), whereas, in case of the Hind foot score (HS), it declined rapidly following the percutaneous tenotomy (0.2) Then the total score (TS) trends to fall to near 0, at the end of 3rd post SFAB (Steenbeek Foot Abduction Brace) routine follow up and is maintained thereafter. Approximately 74. 1% patients ultimately required tenotomy of Tendo Achilles as a part of management and the rate was highest (83.6%) in >30-36 months age group, followed by 80.0% in >24-30 months age group. The relapse rate was estimated within post SFAB routine follow up, 1.9% was within 1st 6 months & 2-1% within 6 12 months after removal of bracing. All steps in all patients were done as day case procedures. No cases of posterior-medial release was required, as like the conventional or the original Ponseti treatment protocol, hence found cost effective to the patients with excellent patient's compliance (P<0.01)Bang Med J (Khulna) 2015; 48 : 11-15

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R, Muralidhar Reddy. "OUTCOME OF CLUBFOOT MANAGEMENT BY PONSETI TECHNIQUE- A PROSPECTIVE STUDY." Journal of Evidence Based Medicine and Healthcare 5, no. 38 (September 11, 2018): 2703–8. http://dx.doi.org/10.18410/jebmh/2018/554.

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Mang'oli, Paul, Joseph Theuri, Tobias Kollmann, and Noni E. MacDonald. "Ponseti clubfoot management: Experience with the Steenbeek foot abduction brace." Paediatrics & Child Health 19, no. 10 (December 2014): 513–14. http://dx.doi.org/10.1093/pch/19.10.513.

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Zhao, Dahang, Hai Li, Li Zhao, Ken N. Kuo, Xuan Yang, Zhenkai Wu, Jianlin Liu, and Jie Zhu. "Prognosticating Factors of Relapse in Clubfoot Management by Ponseti Method." Journal of Pediatric Orthopaedics 38, no. 10 (2018): 514–20. http://dx.doi.org/10.1097/bpo.0000000000000870.

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Mejabi, Joseph Olorunsogo, Oluwadare Esan, Olayinka Oladiran Adegbehingbe, Joseph Effiong Asuquo, and Akinyele Lawrence Akinyoola. "A prospective cohort study on comparison of early outcome of classical Ponseti and modified Ponseti post tenotomy in clubfoot management." Annals of Medicine and Surgery 24 (December 2017): 34–37. http://dx.doi.org/10.1016/j.amsu.2017.09.014.

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Sananta, Panji, Respati Suryanto Dradjat, Tofan Margaret Dwi Saputra, and Muhammad Alwy Sugiarto. "Ponseti method under general anesthesia is an effective method of treatment for neglected congenital talipes equino varus: a cohort study." F1000Research 11 (March 29, 2022): 361. http://dx.doi.org/10.12688/f1000research.109284.1.

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Background:Neglected congenital talipes equino varus (CTEV) deformity is common in poorer developing countries. If ignored, children with CTEV result in callosity, potential bone and skin infection, and a significant mobility limitation resulting from stiffness. There are many management options that can be used to manage neglected CTEV. Until now, the Ponseti casting technique is a gold standard for treating CTEV without surgery. Ponseti methods effectively correct CTEV deformity in all ages. However, patients treated with the Ponseti process will suffer pain during correction in daily practice. Therefore, it is necessary to give anesthesia to reduce pain and relax soft tissues to achieve a satisfactory outcome when correction is carried out. Methods:This study design is a retrospective. Our study consisted of 32 patients, divided into two groups. Group A is the group that was treated with the Ponseti using general anesthesia (GA), and group B is the group without using GA. The children were anesthetized using isoflurane inhalation with 1-2 mcg/kg. After that, we performed serial casting every week and evaluated the outcome and number change cast between using GA and without GA. Lastly, we used a paired t-test statistical analysis to determine the relationship between before and after therapy. Results:In group A, the mean Pirani score significantly reduced from 5.81 ± 0.403 to 0.625 ± 0.40. In contrast with roup B, where the mean Pirani score slightly decreased from 5.81 ± 0.403 to 4.437 ± 1.093. After the last serial cast, in group A, only four cast replacements were needed to achieve a good outcome, whereas, in group B, the results remained unsatisfactory after 10 cast changes. Conclusions: Ponseti method under GA is an effective treatment and reduced the number of cast changes for neglected CTEV.

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Ahmed, Usman, Ayesha Saeed, Mian Maqbool Hussain, Mumtaz Hussain, Abdul Latif Sami, and Javed Iqbal. "Success of Ponseti Method in Idiopathic Club Feet of <2 Years and 2-5 years of age – A Comparative Study." Pakistan Journal of Medical and Health Sciences 15, no. 11 (November 30, 2021): 3022–25. http://dx.doi.org/10.53350/pjmhs2115113022.

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Background: The Ponseti technique is the gold standard for treatment of clubfoot. However, the data in walking children is still limited and results are ill defined. Aim: We prospectively compared Ponseti method in clubfoot patients aged <2 and between 2 to 5 years in our local scenario. Methods: A total of 40 patients were included in the study through non-probability purposive sampling. The patients were examined, classified (Goldner and Fitch classification) and demographic information was recorded. They were explained about the risk and informed consent was taken. In group A, patients were below 2 years of age while in group B, patients were between 2-5 years of age. Ponseti casting was performed by a designated team. Follow-up was done for 6 months from the correction of feet. Results: We received 27(67.5%) male and 13(32.5%) female patients .The male to female ratio was 2:1. The mean age of patients in group A and B was 0.8±0.70 years and 4.3±2.1 years respectively. There was no statistical difference of severity of deformity of clubfoot in both study groups, p-value>0.05. In group A, 17 (85%) patients had success of procedure while in group B the success was achieved in 11 (55%) patients. The success rate was statistically significantly higher in group-A as compared to group B, p-value<0.001 Conclusion: Patient aged <2 years have significantly higher success rate as compared to patients aged between 2-5 years. So we recommend the Ponseti method as standard therapy in clubfoot management for patients with age<2 years and for correction of mild and moderate deformities in patients between 2 to 5 years. Keywords: Clubfoot, Congenital talipes equinovarus, Ponseti method

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Jan, Wazir Fahad, Alamgir Jahan, Mohd Yahya Dar, and Firdous Ahmad Bangroo. "A study on management of congenital clubfoot by Ponsetti technique in a rural medical college in India." International Journal of Research in Orthopaedics 5, no. 1 (December 25, 2018): 172. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20185342.

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<p class="abstract"><strong>Background:</strong> Congenital clubfoot also known as CTEV (congenital talipus equinovarus) is a common and debilitating congenital musculoskeletal anamoly affecting the children across the world with a slight preponderence in third world countries. The Ponseti technique of casting has now become the mainstay of treatment of this condition. This method is especially effective in rural and underdeveloped areas with limited health care facilities. The purpose of this study was to evaluate the effectiveness of the Ponsetti technique in the correction of this deformity, thorough the assessment of modified Pirani score.</p><p class="abstract"><strong>Methods:</strong> This was a prospective observational study conducted on 75 patients of either sex with 100 feet, with an average age of 3.6 months presenting to the Orthopaedic OPD of SHKM Government Medical College Hospital, Nalhar, Nuh, Haryana between September 2015 and September 2017, with a diagnosis of congenital clubfoot. All the patients were treated with Ponsetti technique and the results were analysed through the assessment of modified Pirani score. The patients were followed up for a peroid of 1 year after attainment of correction.<strong></strong></p><p class="abstract"><strong>Results:</strong> Majority of the patients obtained full correction with this method. The mean value of the modified Pirani score improved from the pre-treatment value of 5.30 to 0.36 at the final follow up. The average number of casts required for full correction was 7.32.</p><p><strong>Conclusions:</strong> Thus results of our study demonstrate that the Ponsetti method is a safe and effective method of treatment for congenital clubfoot, especially in rural and underdeveloped regions. </p>

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Hosseinzadeh, Pooya, Derek M. Kelly, and Lewis E. Zionts. "Management of the Relapsed Clubfoot Following Treatment Using the Ponseti Method." Journal of the American Academy of Orthopaedic Surgeons 25, no. 3 (March 2017): 195–203. http://dx.doi.org/10.5435/jaaos-d-15-00624.

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Servino, Tidahy Ando, Ranaivondrambola Ando Tatiana, Raoninah Hanitriniony, and Solofomalala Gaëtan Duval. "Results of Ponseti Method in the Management of the Congenital Clubfoot." Open Journal of Therapy and Rehabilitation 10, no. 03 (2022): 101–10. http://dx.doi.org/10.4236/ojtr.2022.103009.

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Abdou Mar’e`i, Mohsen Mohamed, Reda El-Kady, Sameh Mohamed Holyl, and Lamin Abdel-Salam Mohamed Ismail. "Talipes Equinovarus surgical Management after Failure of Ponseti Technique in Children." Egyptian Journal of Hospital Medicine 87, no. 1 (April 1, 2022): 1348–53. http://dx.doi.org/10.21608/ejhm.2022.223610.

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ElTayeby, Hazem M. "Multiple Tenotomies after Ponseti Method for Management of Severe Rigid Clubfoot." Journal of Foot and Ankle Surgery 51, no. 2 (March 2012): 156–60. http://dx.doi.org/10.1053/j.jfas.2011.10.038.

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Karami, Mohsen, Pooneh Dehghan, Farshid Moshiri, and Mehrdad Sadighi Shamami. "Effect of unintentional partial Achilles tenotomy on Ponseti clubfoot management outcomes." Journal of Pediatric Orthopaedics B 24, no. 1 (January 2015): 1–5. http://dx.doi.org/10.1097/bpb.0000000000000120.

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Abbas, Mazhar, Owais A. Qureshi, Lateef Z. Jeelani, Qamar Azam, Abdul Q. Khan, and Aamir B. Sabir. "Management of Congenital Talipes Equinovarus by Ponseti Technique: A Clinical Study." Journal of Foot and Ankle Surgery 47, no. 6 (November 2008): 541–45. http://dx.doi.org/10.1053/j.jfas.2008.07.002.

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Bhatiwal, Sunil Kumar, B. L. Chopra, B. L. Khajotia, and Shakti Chauhan. "Idiopathic clubfoot treated by Ponseti method: a series of 300 cases." International Journal of Research in Orthopaedics 4, no. 6 (October 24, 2018): 954. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20184383.

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<p class="abstract"><strong>Background:</strong> Clubfoot is a complicated deformity of the foot. It is one of the commonest congenital deformities in children. The main aim of this study was to evaluate the efficacy management of clubfoot by Ponseti method.</p><p class="abstract"><strong>Methods:</strong> This prospective study included 300 children (456 club feet) below the age of 2 years with idiopathic clubfeet from January 2013 to December 2017. In all the cases the Ponseti method was used for the management. The severity of the deformity was assessed with the help of the Pirani score and clinical evaluation of the foot was done.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 300 patients 204 patients were male and 96 patients were female and 144 were unilateral clubfoot and 156 were bilateral cases of clubfoot. The mean number of casts required for correction was 5.4 (4–10). Out of 456 clubfeet 356 (78%) feet were required tenotomy. There was relapse seen in 36 (7.9%) feet which had to be managed with 2–3 serial manipulations and casting and these resolved. Excellent result found in our study in 92% cases, good results were found in 5% cases and poor results were found in 3% cases.</p><p class="abstract"><strong>Conclusions:</strong> Ponseti technique is a very useful and effective method of management of idiopathic clubfoot up to 2 year of age.</p>

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