Long-Term Follow-Up of Congenital Clubfoot Treated with Ponseti Method: A Cross-Sectional Study

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Abstract

Background/Objectives: Commonly known as clubfoot, congenital talipes equinovarus (CTEV) is a structural deformity characterized by cavus, adductus, varus, and equinus (CAVE) positioning of the foot. Idiopathic clubfoot requires prompt treatment to achieve functional, pain-free, and aesthetically normal feet. The Ponseti method is a conservative treatment involving serial manipulation, casting, and Achilles tenotomy, which has demonstrated high success rates. This study evaluated 10 years of experience using the Ponseti method. Methods: A total of 91 patients (146 feet) with idiopathic clubfoot were treated between 2011 and 2023. The severity of deformities was assessed using the Pirani score. Data collection included demographic details, number of casts, tenotomy procedures, adherence to the Denis Browne brace protocol, and complications. A retrospective and follow-up analysis was conducted with 72 patients (118 feet) who met the minimum follow-up requirement of 12 months (mean follow-up: 54.15 months). Outcomes were measured using the Ponseti functional scoring system. Results: Initial correction of deformities was achieved in all 91 patients (100%). The average number of casts applied was 9.51 per patient. Percutaneous Achilles tenotomy was performed in 91.21% of cases. Relapse occurred in 22.2% of patients, which required additional treatments. The outcomes were excellent in 77.7% of cases, good in 13.88%, fair in 6.94%, and poor in 1.38%. Conclusions: The Ponseti method is effective for idiopathic clubfoot treatment and achieves high rates of initial correction, favorable long-term outcomes, and minimal complications. These results confirm its reliability and align with previously reported success rates.

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