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. 2016 May 4;51(3):313-8.
doi: 10.1016/j.rboe.2015.06.020. eCollection 2016 May-Jun.

Treatment of congenital clubfoot using Ponseti method

Alceu José Fornari Gomes Chueire  1 , Guaracy Carvalho Filho  1 , Otto Yosuke Kobayashi  1 , Leonardo Carrenho  1
Affiliations

Treatment of congenital clubfoot using Ponseti method

Alceu José Fornari Gomes Chueire et al. Rev Bras Ortop. .

Abstract
in English, Portuguese

Objective: To quantitatively and qualitatively analyze the results from treatment of congenital clubfoot with a mean follow-up of 4.6 years.

Methods: 26 patients who underwent treatment by means of the Ponseti method were analyzed (total of 39 feet). The mean age at the start of the treatment was 5.65 months. The mean length of the follow-up subsequent to tenotomy of the Achilles tendon was 4.6 years. Patients with secondary clubfoot were excluded. Epidemiological data, radiographic measurements on the Kite angle and data from a satisfaction questionnaire and the Laaveg questionnaire were analyzed.

Results: Among the 26 patients treated, one presented recurrence of the deformity and had to return to the beginning of the treatment. The mean score from the questionnaire and physical examination was 89.76 points, and this result was considered good. 99% of the patients responded that their feet never hurt or hurt only upon great activity; 88% said that their feet did not limit their activities; and 96% said that they were very satisfied or satisfied with the results from the treatment. The mean Kite angle in anteroposterior view was 28.14° and it was 26.11° in lateral view.

Conclusion: Treatment for idiopathic congenital clubfoot by means of the Ponseti method brings better results together with less soft-tissue injury, thus confirming the effectiveness and good reproducibility of this method.

Objetivo: Analisar quantitativa e qualitativamente os resultados do tratamento do pé torto congênito com seguimento médio de 4,6 anos.

Métodos: Foram analisados 26 pacientes que fizeram tratamento pelo método de Ponseti, total de 39 pés. A média da idade do início do tratamento foi 5,65 meses. O tempo de seguimento após a tenotomia do tendão de Aquiles foi em média de 4,6 anos. Foram excluídos pacientes com pé torto secundário. Foram analisados dados epidemiológicos e mensurações radiográficas do ângulo de Kite e aplicados questionário de satisfação e questionário de Laaveg.

Resultados: Dos 26 pacientes tratados, um apresentou recidiva da deformidade, foi necessário retornar ao início do tratamento. A pontuação média do questionário e do exame físico foi de 89,76, resultado considerado bom; 99% dos pacientes responderam que os pés nunca doem ou doem somente aos grandes esforços; 88% responderam que o pé não limita as atividades; 96% responderam que estão muito satisfeitos ou satisfeitos com os resultados do tratamento. A média do ângulo de Kite na incidência anteroposterior foi de 28,14° e no perfil 26,11̊.

Conclusão: O tratamento para pé torto congênito idiopático pelo método Ponseti é o que traz melhores resultados associado a menor lesão de partes moles, o que confirma a eficácia e a boa reprodutibilidade do método.

Keywords: Clubfoot; Congenital; Lower extremity deformities; Manipulation; Orthopedic; Treatment outcome.

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Figures

Fig. 1
Fig. 1
Kite angle in anteroposterior view.
Fig. 2
Fig. 2
Kite angle in lateral view.
Fig. 3
Fig. 3
Long leg plaster cast correcting cavus, varus, and adduction.
Fig. 4
Fig. 4
Seven-year-old patient, five years after Achilles tenotomy.
See this image and copyright information in PMC

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