1.Ponseti method of treating clubfoot - Is there difference if treatment is started before or after one month of age?
Bryan Lee Yen Pei ; Mazelan Ali ; Roshan Gunalan ; Mohammed Ziyad Albaker ; Saw Aik
The Medical Journal of Malaysia 2020;75(5):510-513
Introduction: Most of the authors currently agree that
congenital talipes equinovarus (CTEV) or idiopathic clubfoot
can be effectively treated with the Ponseti method instead of
extensive soft tissue surgery. This study was conducted to
investigate whether there is a difference in the outcome
between starting treatment before one month of age or after
that age.
Methods: This is a retrospective study on babies with CTEV
treated in University Malaya Medical Centre from 2013 to
2017. The 54 babies (35 boys and 19 girls) were divided into
two cohorts, Group 1 that had treatment before the age of
one month, and Group 2 that had treatment after one month
old. The number of cast changes, rate of full correction, and
rate of relapse after treatment were compared between the
two groups.
Results: Of the 54 babies, with 77 CTEV treated during the
period, our outcome showed that the mean number of cast
change was 5.9 for Group 1 and 5.7 for Group 2. The
difference was not statistically significant. All the affected
feet (100%) achieved full correction. One foot in the Group 1
relapsed, while three feet in Group 2 relapsed, but the
difference was also not statistically significant. All of the
relapsed feet were successfully treated with repeated
Ponseti method.
Conclusions: Treating CTEV using Ponseti method starting
after one month was not associated with more casting
change of higher rate of relapse