Treatment of Congenital Talipes Equinovarus using Accelerated Ponseti Method by Fast Casting and Needle Tenotomy

Document Type : Original Article

Authors

Department of Orthopedic Surgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt.

Abstract

Background: Congenital Talipes Equinovarus [CTEV] or clubfoot is a common orthopedic deformity that if untreated, leads to significant functional impairment. The Ponseti method, a non-surgical approach involving gentle manipulations, serial casting, and often percutaneous Achilles tenotomy, has become the gold standard due to its effectiveness in correcting the deformity while preserving the foot function. An accelerated Ponseti method aims to reduce treatment duration.
Aim of the Work: This study aimed to evaluate the efficacy and safety of the accelerated Ponseti technique in managing the clubfoot among 20 infants under three months of age, treated at the Orthopedic Department, Al-Azhar University Hospital in Damietta, Egypt.
Patients and Methods: A prospective clinical trial was conducted from March 2024 to March 2025. Inclusion criteria were infants under three months with idiopathic clubfoot, no prior surgery, and no neurological or syndromic anomalies. The Ponseti technique involved daily manipulations and above-knee casting until 50° abduction was achieved. Percutaneous Achilles tenotomy was performed for residual equinus in most cases. Statistical analysis used SPSS version 26, with a p-value < 0.05 considered significant. Ethical approval and informed consent from guardians were obtained.
Results: The study included 20 infants [average age 2.1 months; 60% male; 35% bilateral involvement]. Initial Pirani scores averaged 5.2 at presentation, improving to 0.9 [an 82.3% improvement]. The average number of casts was 5.6, with intervals of 6 days. Sixty percent of patients require a tenotomy, typically around 2 months of age. Complications were low [15%], primarily mild discomfort [10%].
Conclusion: The accelerated Ponseti method is a safe, effective, and feasible approach for treating congenital clubfoot in infants, particularly in resource-limited settings. It demonstrates high correction rates, low complications and relapses, and high parental satisfaction. Early treatment initiation within the first three months is crucial for maximizing outcomes. 

Keywords

Main Subjects

Files

Share

How to cite

Statistics