Umar Hayat, Abdus Samad Khan, Muhammad Siraj.
Outcome of Ponseti Method in Correcting Neglected Idiopathic Club Foot upto 5 Years of Age.
Ophthalmol Update Jan ;15(2):157-9.

Background: Efficacy of Ponseti method is well established in children up to 2 years of age. The success of this method in neglected cases and older children is not known. Method: This study was conducted in orthopaedic department of Khyber Teaching Hospital, Peshawar from Jan 2012 to Jan 2015. We prospectively studied 14 children (20 feet) with idiopathic club feet and no history of any previous treatment. All the cases were treated by Ponseti method with few modifications. The mean age at presentation was 3.2 years (1.8 to 5). Results: In 9cases (12 feet) painless plantigrade foot was achieved with no need for any extensive soft tissue or bony procedures. Recurrent equinus was observed in 2 patients (3 feet) which were corrected by second tenotomy. Repeat castings were done in 2 patients (4 feet) who had recurrence of fore foot adduction. Posterior release for full correction of the equinus deformity was done in 4 patients (6 feet) who failed to correct fully after ponseti technique. One patient (2 feet) was lost to follow up. Conclusion: We conclude that Ponseti technique is a safe and cost effective method even for the treatment of neglected cases of idiopathic club foot upto 5 years of age.

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