Ponseti Versus Kite's Method of Treatment for Idiopathic Clubfoot.

Abstract

Introduction : Idiopatic congenital talipes equinovarus deformities in infants are difcult to treat due to its complicated pathoanatomy of the growing foot. As clubfoot deformities are pliable in the early weeks of life, treatment preserved is always conservative. Both manipulation and casting methods of Kite and Ponseti are commonly used with good outcomes 1. Though most orthopaedicians prioritize using Ponseti method, advantages and disadvantages of both treatment should be taken into consideration when selecting the treatment. So, we have decide to carry out a comparative study between Kite's and Ponseti method in the treatment of idiopathic clubfoot. 33 patients (48 feets) having idiopathic CTEV were randomized and divided into Materials and methods : two groups. 18 infants (26 feet) were selected and treated by Ponseti method and 15 infants (22 feet) were treated by Kite's method. The results of both group were compared based on Pirani score, time and number of casts required for correction, relapse and percentage of feet corrected. Ponseti Results : method had higher satisfactory correction rate (91.67% versus 80.95%), required less number of casts ( 7.57 versus 11.76), less duration of cast ( 53 days versus 82.35 days) and lesser percentage of relapse ( 8.33 % versus 9.52%). The relapse were corrected by remanipulation in both the groups. In case of bilateral idiopathic CTEV mean Pirani score decreased faster in the Ponseti group compared to Kite's group. The difference was statistically signicant 3rd week onwards in left sided CTEV and 4th week onwards in right sided CTEV. In case of unilateral idiopathic CTEV, the mean Pirani score in Ponseti group decreased faster in Ponseti group compared to Kite's group and the difference was statistically signicant 3rd week onwards. Both Ponseti and Kite's method of casting are effe Conclusion : ctive in correcting idiopathic CTEV deformities. Though correction rate was almost similar in both methods, Ponseti method proved slightly better than Kite's in correcting deformities faster with relatively lesser number and duration of casts. The Kite's method had an advantage of not needing any minor surgical procedure for the correction of deformity.