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Randomized Controlled Trial
. 2008 Jun;32(3):409-13.
doi: 10.1007/s00264-007-0332-y. Epub 2007 Feb 24.

Ponseti's vs. Kite's method in the treatment of clubfoot--a prospective randomised study

Alok Sud  1 , Akshay Tiwari, Deep Sharma, Sudhir Kapoor
Affiliations
Randomized Controlled Trial

Ponseti's vs. Kite's method in the treatment of clubfoot--a prospective randomised study

Alok Sud et al. Int Orthop. 2008 Jun.

Abstract
in English, French

Ponseti's and Kite's methods of conservative management in idiopathic congenital clubfoot were compared in a prospective randomised study consisting of 45 infants (67 feet) younger than 3 months, from March 2003 through February 2004. There were 36 and 31 feet that underwent treatment by Ponseti's and Kite's methods, respectively. After an average follow-up of 27.24 months in the Ponseti group, correction was achieved in 33 feet (91.7%), with only three patients requiring surgical management. There were seven relapses (21.1%), all of which were corrected conservatively. However, two of these required surgical intervention on showing a relapse again in the second year. In the Kite group, we achieved correction in 21 feet (67.7%) after an average follow-up of 24.8 months, with ten patients requiring surgical intervention. There were eight relapses of which only four could be corrected conservatively. We could also achieve correction in very severe feet (Dimeglio classification) in a significantly higher percentage using Ponseti's method, in significantly lesser time and with fewer casts. We are of the opinion that Ponseti's method is superior to Kite's method in achieving correction in idiopathic clubfeet in a relatively shorter period of time when used to treat young infants.

Les méthodes de Ponseti et de Kite dans le traitement conservateur du pied bot congénital sont comparées dans une étude prospective randomisée incluant 45 enfants (67 pieds), traités avant 3 mois, étude réalisée de mars 2003 à février 2004. Trente-six pieds ont été traités selon la méthode de Ponseti et 31 selon la méthode de Kite. Le suivi moyen a été de 27.24 mois dans le groupe de Ponseti. La correction a été réalisée dans 33 pieds (91.7%), seulement 3 patients ont nécessité un traitement chirurgical. Il y a eu 7 récidives (21.1%), tous les pieds ont été traités avec un traitement conservateur. Cependant deux pieds nécessitant un traitement chirurgical ont montré une récidive dans la deuxième année. Dans le groupe Kite, la correction a été réalisée dans 21 pieds (67.7%) avec un suivi moyen de 24.8 mois, 10 patients ont nécessité un traitement chirurgical et 8 récidives dont 4 ont bénéficié d’un traitement conservateur. Nous pouvons traiter les pieds sévères (classification de Dimeglio) avec un bon pourcentage et bon résultat en utilisant la méthode de Ponseti qui permet de diminuer le temps de traitement et le nombre de plâtre. Nous pouvons conclure que la méthode de Ponseti est supérieure à la méthode de Kite, elle permet un temps de traitement plus court dans le traitement des pieds bots varus équins de l’enfant.

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References

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