Traditional and accelerated Ponseti technique: a comparative study

Abstract

The purpose of this study was to compare the results of traditional and accelerated Ponseti techniques to clarify whether this technique can be done safely in reduced time with complete correction of the deformity and without complications. A total of 66 feet in 41 children with idiopathic club foot and with Pirani score no <4 were included; of these, 34 feet in 20 children were managed with the traditional Ponseti method with one cast a week, in the other 32 feet in 21 children, an accelerated technique was used with casting twice a week, and the Pirani score was used for initial assessment and for follow-up. The results were comparable for both groups; the mean number of casts for full correction was 4.88 ± 0.88 in the traditional group and 5.16 ± 0.72 in the accelerated group. Initial correction was obtained in all cases in both groups, and relapses were observed in 14.7 % in the traditional group and in 15.6 % in the accelerated group. Deformities required from four to seven casts for correction in both groups. There was a statistically significant reduction in the mean time required for correction from onset of manipulation till tenotomy or correction of equines without tenotomy which was 33.36 ± 6.69 days (21-42 days) in the traditional Ponseti group and 18.13 ± 3.02 days (11-22 days) in accelerated Ponseti (P = 0.001). Accelerated Ponseti technique significantly reduces the correction time without affecting the final results; it is quite as safe and effective as the traditional Ponseti.

Ponseti method in the management of clubfoot under 2 years of age: A systematic review

“…At the second stages of screening process, we excluded 33 articles due to the following main reasons: full text was not available, full text articles was not in English, conference proceedings, duplication of articles, children over than 2 years of age, neglected clubfoot, clubfoot associated with other problems, survey studies, short-term outcome, other treatments such as operative treatment, Ponseti method with different casting materials, different purpose of the studies other than finding effectiveness of Ponseti method among children with clubfoot. As a result, 12 studies were satisfied our selection criteria for the systematic review study after application of all inclusion and exclusion criteria in 45 articles [49–60]. Among the twelve studies, there were four prospective studies [49–52], one multicenter clinical study [53], one consecutive clinical series [54], two randomized controlled study [55, 56], one cohort study [57] and other three clinical studies [58–60].…”

“…As a result, 12 studies were satisfied our selection criteria for the systematic review study after application of all inclusion and exclusion criteria in 45 articles [49–60]. Among the twelve studies, there were four prospective studies [49–52], one multicenter clinical study [53], one consecutive clinical series [54], two randomized controlled study [55, 56], one cohort study [57] and other three clinical studies [58–60]. …”

“…There is a total of 852 clubfoot children with 1206 clubfeet were included in this review. In the 12 studies, a total of 293 bilateral clubfoot children are identified [49, 50, 52, 53, 55, 56, 58–60]. Few studies reported that the affected side of the foot is either right side or left side of the foot.…”

“…There are five studies used Kite method among the twelve selected studies [50, 55–57, 59]. One of the study used accelerated Ponseti method to compare the current existing method of intervention for the clubfoot deformity, and the results of this study stated that the accelerated Ponseti method is safe as a traditional Ponseti method of treatment for clubfoot intervention [49]. The Ponseti treatment regime included manipulation, serial casting, Achilles tendon tenotomy and Bracing—Foot abduction brace [7, 19, 20].…”

Doğuştan çarpık ayak – Ponseti sonrası gelişmeler

“…[14] 2015 yılının başlarında yayımlanan başka bir çalışmada, 41 çocu-ğun 66 ayağında, haftada iki kez alçı yapılan 33 ayak ile ponseti protokolü uygulanan 33 ayak karşılaştırıl-mış ve hızlandırılmış tedavinin ilk düzeltme aşamasını hızlandırdığı ve en az klasik protokol kadar etkin olduğu bildirilmiştir. [15] Pirani, bu konuda yaptığı manyetik rezonans (MR) görüntüleme çalışmasında, sık alçı değişiminin bu yaş grubundaki hızlı büyümeye adaptasyonu zorlaştıracağını bildirmiş ve yukarıdaki görüşe karşı fikir beyan etmiştir. [16] Manipülasyon ve alçı tekniğine ait tamamiyle farklı bir öneri getiren, 2008 yılında JBJS Br'de (The Journal of Bone & Joint Surgery [British Volume]) yayımlanmış bir çalışmada, 51 bebeğin 80 ayağında alçılama tekniği, diz altı softcast alçı kullanılarak modifiye edilmiştir.…”