Syndromic clubfoot beyond arthrogryposis and myelomeningocele: orthopedic treatment with Ponseti method.

The research article is a retrospective analysis of the application of the Ponseti method in treating syndromic clubfoot, a common congenital foot deformity associated with musculoskeletal, neurological, or connective tissue conditions.

Objective of the Research

• The main focus of this study is to assess the effect of the Ponseti method in treating syndromic clubfoot, a congenital deformity that affects bone, muscle, and tendon structure in the foot and is frequently associated with various neurological or musculoskeletal syndromes.

Methodology

• A retrospective study was conducted, focusing on six patients (nine feet in total) who received Ponseti method treatment at a tertiary center.
• All patients had a minimum follow-up period of two years, with the longest being 18 years.
• The researchers evaluated the effectiveness of the treatment using the Pirani classification, a scale that measures the severity of clubfoot before and after treatment.

Results & Findings

• An average of 6.5 casts was used in the Ponseti treatment for each patient.
• The mean Pirani score decreased from 5.2 before treatment to 1.27 after treatment, indicating an average improvement of 3.93 points.
• More than half of the cases required Achilles tendon lengthening to correct the equinus deformity.
• An ankle-foot orthosis (AFO) was utilized to prevent recurrence in patients with unequivalent limb lengths (dysmetria) or cognitive delay (psychomotor retardation).
• The most common residual deformity was the adductus (inward orientation of the foot).
• One patient experienced a relapse twice.

Conclusions

• The Ponseti method produced effective results in correcting syndromic clubfoot deformity. However, compared to other pediatric foot pathologies, a greater number of corrective casts were required for this method.