DefinePK

Abstract

Background: Ponseti technique for club foot treatment has become morepopular during the last decade. But the most common problem following correction byPonseti technique is the relapse of deformity. Setting: Dow University Hospital as well asother hospitals were included in the study. Period: April 2013 to April 2016. Methods: 335children with idiopathic club foot presented in OPD with relapse, treated with Ponseti technique.Pirani scoring was used to assess the severity of relapse. Children with both unilateral andbilateral involvement, aged up to 5 years were included. 335 children with idiopathic club feetwho underwent treatment with Ponseti technique, presented with relapse of deformity wereenrolled in the study. Results: There were 207(59.7%) boys and 128(37%) girls. Mean age atpresentation for casting (previous treatment age) was 5.98 months (SD ±6.07), and 153(44.2%)had Right sided involvement, 112 (32.4%) had left sided involvement and 69(19.9%) hadbilateral involvement. Mean age at which relapse occurred was 24.7 months (SD ±7.35). Themean Pirani score was 4.78 (SD ±4.30). Percutaneous heel cord tenotomy was done in 286(82.7%) children. Number of cast to maintain initial correction was 7.58 (SD ±1.19).Out of 335patients 246(71.1) used brace and out of them 123 (50%) used brace up to one year, 70 (25.5%)used for1-2 years, 30 (15.5%) used for 2-3 years and 23 (9%) used for 3-4 years. Conclusion:Ponseti method is safe and effective method of treatment for club foot. Despite the proper use ofPonseti method, relapses and recurrences still occurs due to certain factors. The best treatmentfor recurrent club foot is prevention in the form of consistent primary treatment, constant use ofbraces and regular follow up