Evaluation of Kite and Ponseti Methods in the Treatment of Idiopathic Congenital Clubfoot

Abstract

Objective:Clubfoot is one of the most common congenital deformities affecting the musculoskeletal system. The main conservative treatment for clubfoot includes the Ponseti's and Kite's methods. This study aimed to perform a comparative evaluation of the effectiveness of the Ponseti and Kite approaches for the conservative treatment of clubfoot.Methods:One hundred children with clubfoot abnormality, visiting the Martagão Gesteira Hospital, were divided in two groups. The first group received conservative treatment using the Kite method and the second group received conservative treatment using the Ponseti method. At the end of the treatment, both groups were evaluated based on the Pirani classification to verify whether there had been an adequate correction of the deformity. The variables studied included correction of deformity, age, sex, and laterality.Results:The effectiveness of the Kite and Ponseti methods of conservative treatment showed significant statistical differences.Conclusion:The present study shows that the efficacy of conservative treatment using the Ponseti method was 18% higher than that of the Kite method. Level of evidence II, randomized clinical trial.

A modification of the Ponseti method for clubfoot management: A prospective comparative study

“… 4 , 5 , 7 , 9 , 25 , 26 , 28 , 33 Other factors, such as the low educational level of parents and low annual family income, were associated with poor compliance with bracing and recurrences. 14 , 19 , 32 , 33 , 36 , 39 Some parents wrongly think that once the feet are corrected, it can never recur. 19 , 21 Thus, they consider using the brace as cumbersome, especially in unilateral cases.…”

“… 21 , 22 In addition to the associated rate of surgical release, the results were poor in the long-term follow-up. 8 , 10 , 19 , 22 , 38 , 39 Our new exercise programme is a retention programme that could replace FAB use after achieving correction with standard Ponseti casting and tenotomy. Although many new FAB designs are being proposed and developed, evidence regarding biomechanical effects, clinical outcomes, functionality and patient adherence is limited.…”

“…9,27,30,31,34 The recurrence of the deformity and subsequent surgical interventions were associated with long-term deformity and disability. 7,9,15,29,32,35,39,40 Since most of the recurrences and failures of the Ponseti method are secondary to the lack of compliance and adherence to the FAB use, we are introducing the use of a parent-based exercises programme, replacing the use of FAB, assuming better compliance of the family or caregiver with subsequent low recurrence rate. 9 We conducted this study on a large group of patients in a prospective multicentre study to compare the results of using FAB and our new homebased exercise programme.…”

Effectiveness of the Ponseti Method in the Treatment of Clubfoot: A Systematic Review

“…It is approximately three times more frequent in males than in females. Clubfoot is present unilaterally or bilaterally in 50% of cases [ 2 , 5 , 6 , 7 , 8 ]. Its etiology may be associated with myelodysplasia, arthrogryposis or multiple congenital deformities, but the most common presentation is in isolation, which is considered the idiopathic type [ 2 ].…”

“…These changes will depend on the severity of the soft tissue contracture and the effects it would have on walking. Lack of treatment or improper treatment can cause psychological or functional damage [ 6 , 7 ].…”