It is estimated that more than 100,000 babies are born worldwide each year with congenital clubfoot. Eighty percent of the cases occur in developing nations. Most are untreated or poorly treated. Neglected (older aged) clubfoot causes crushing physical, social, psychological and financial burdens on the patients, their families, and the society. Globally, neglected clubfoot is the most serious cause of physical disability among congenital musculoskeletal defects. A dramatic reduction in radical clubfoot operation has been reported in parts of the world where Ponseti treatment has been introduced. There have been some reports of Ponseti treatment being given successfully to children with neglected clubfoot, but there has been no general acceptance of treating children older than 2 years with this method. Today, these children are probably treated with radical operations or left untreated. The purpose of this study is to examine the results of Ponseti method in old age clubfoot children.
To evaluate the outcome of Ponseti method of clubfoot patients of more than 1.5 years of age.
Materials and Methods: The study was conducted in Patients outdoor department of orthopedic department of CHA where the service is offered for all outpatients who come from all over the country. Patients were selected on the basis of inclusion and exclusion criteria as: Inclusion criteria: Patients with club foot with more than 1.5 years of age, Assessment is executed by qualified Orthopedics, both male and female were included. Exclusion criteria: Patients with age less than 1.5 years, Patients who are medically unstable, Patients who have isolated clubfoot, like metatarsus adductus, heel varus.
Results and Discussion: We have found a statistical significant improvement in ability for the children with congenital clubfoot of more than 1.5 years’ age. Between pre-and post-correction phase Z value is 152.2 (p<0.05) and between post correction and post brace phase Z value is 4.61(p<0.05) which is statistically significant, which is comparable to Abhinav Sinha, Anil Mehtani et al. (2016) study, who studied 41 clubfeet in 30 patients, presenting after the walking age, were evaluated to determine whether the Ponseti method is effective in treating neglected clubfoot. The mean Pirani score was 5.41 before treatment and 0.12 after treatment. All feet (100%) achieved painless plantigrade feet without any extensive soft tissue surgery. Comparison with it in my study mean Pirani score is 5.79 precorrection and 0.04 post correction. 100% correction rate achieved.
Conclusion: The results of treatment of CTEV by PONSETI method is much more efficient and compliant. As PONSETI method has very less dropout, very less recurrence, very good compliance, Less time period of treatment, Less complication. As a whole the clubfoot patients of more than 1.5 years of age getting functional improvement after Ponseti method and the result were significant.