![](images/Newspaper.gif)
Collaboration between Paediatrician and
Orthopaedician in Management of Congenitial
Talipes Equino Varus by Ponseti Method
RC01-RC04
Correspondence
SP Akshatha,
ADI Chunchanagiri Institute of Medical Sciences (AIMS), BG Nagar, Nagamangala (Taluk), Mandya, Karnataka, India.
E-mail: foryourhelp55@gmail.com
Introduction: Congenital Talipes Equino Varus (CTEV) or Clubfoot is one of the commonest orthopaedic problems observed in infants. Deformity involving in utero malalignment of calcaneo-talar-navicular complex of the foot is known as CTEV. Due to lack of treatment capacity and less knowledge about "Appearance, Pulse, Grimace, Activity, and Respiration." (APGAR) Score in low income countries, CTEV end up with neglected clubfoot deformity (untreated children >2 years). About 1-2/1000 live births is the estimated incidence of idiopathic clubfoot.
Aim: To assess the clinical profile and efficacy of Ponseti technique in the management and treatment of CTEV by Paediatrician and Orthopaedician collaboration.
Materials and Methods: The observational study was conducted at AdiChunchanagiri Institute of Medical Sciences (AIMS). The data was recorded in a standard predesigned proforma which contained all details of patients like name, age, sex, parent details, address, family history, pregnancy and delivery details of mother, any prior treatment taken for clubfoot and examination details of spine, hips, upper and lower limbs with both feet and also other systems for associated clinical problems. The parents of the patients visiting Paediatric Out Patient’s Department (OPD) with CTEV were informed regarding the deformity and were sent to Orthopaedic Department. In Orthopaedic Department, after counselling of the parents regarding the ponseti method, all patients were treated and managed. All patients were followed over a two year period and assessed for any deformities which were subsequently managed surgically. All the data was documented, statistically analysed using suitable statistical methods.
Results: Total 53 patients had 81 idiopathic CTEV or Clubfoot between the period of three years from 2015 to 2018. The age of patients varied upto one year after birth. Among 53 patients, 38 (72%) were males and 15 (28%) were females. Out of 53 infants, 35 had one clubfoot and 23 had bilateral clubfoot (total 81 clubfoot in 53 infants). The mean age of initial presentation to treatment was 3.5 weeks, 11 out of 53 infants came in 1st week of life. Out of 53 infants, 21,14,6,5,4,2 were followed-up for 7-12 months, 13-18 months, 0-6 months, 25-30 months, 19- 24 months and 31-36 months, respectively. Out of 81 clubfoot; 76 (93.83%) had achieved near normal correction, five clubfoot (6.17%) required posteromedial soft tissue release, 67 foot (82.71%) had undergone percuteneoustenotomy and nine foot (11.11%) got corrected without tenotomy.
Conclusion: CTEV or clubfoot is treated very safely and effectively by using ponseti method. It is rapidly decreasing the necessity of extensive surgery. This method should be encouraged to be set as the gold standard treatment of congenital clubfoot or CTEV by national efforts.