The Ponseti Method Followed by Minimally Invasive Surgery as Method of Choice in Treatment of Congenital Talipes Equinovarus: Review Article

Abstract

The objective of the study was to evaluate minimally invasive methods in treatment of congenital clubfoot. Congenital talipes equinovarus (CTEV), or clubfoot, is the most common congenital foot deformity, occurring in 1 to 2 in 1000 live births. CTEV etiology is not yet completely clear. Essentially, the deformity is the result of an intrauterine dislocation of the joints between the talus, calcaneus, navicular and cuboid bone and it includes four components: cavus, adductus, varus and equinus (CAVE). The diagnosis is made by a clinical examination and foot radiography. The treatment is based on the repositioning of the dislocated joints. There are different treatment modalities available, from conservative to exclusively surgical CTEV treatment. The Ponseti method is a primarily conservative treatment method using corrective long-leg casts, sometimes associated with minimal surgical intervention -Achilles tenotomy, followed by the use of an abduction brace. If needed, less invasive surgery ("a la carte") might be used to correct uncorrected components of CTEV. Based on the reports published from 2010 to 2020, as retrieved from databases (PubMed, Medline, Scopus), pertaining mostly to conservative treatment methods and primarily to the Ponseti method and based on the comparison between the Ponseti method and surgical methods of treatment, as well as other conservative methods of treatment, it can be concluded that the Ponseti method is the method of choice for the treatment of congenital CTEV in children today. Conclusion − The Ponseti treatment method, if used on time, fulfills all requirements that are expected from a contemporary medical procedure: simplicity in performance, minimally invasive, wide availability, cost effectiveness and successful treatment results.

Cost-Utility Analysis of CTEV Treatment by Ponseti Method in Siaga Utama Orthopedic Hospital

“…These findings align with research from (Hussain et al, 2014) which explains the cost-effectiveness of clubfoot with onset in Pakistan. While a study from (Ducic et al, 2021;Shabtai et al, 2014) evaluates minimally invasive methods in treating congenital clubfoot. The findings of his research demonstrate that The Ponseti treatment method, if used on time, fulfills all the requirements that are expected from a contemporary medical procedure: simplicity in performance, minimally invasive, wide availability, cost-effectiveness, and successful treatment results.…”