The Mansoura experience in the treatment of idiopathic clubfoot deformity using the Ponseti technique.
Elshenawy EM, Hassanen EY, Ramadam AI, Ibrahim MM.
Acta Orthop Belg. 2008 Oct;74(5):659-66.
The purpose of this study was to evaluate prospectively the results of the Ponseti technique in the treatment of congenital idiopathic clubfoot, to assess the factors that influenced the results and to report the complications that occurred. Seventy one congenital idiopathic clubfeet in 45 patients were treated with serial casting performed at weekly intervals, as described by Ponseti. The mean age at presentation was 64.6 days (range: 3 to 346 days). The average follow-up period was 26.3 months (range: 24-29 months). The results were considered good when there was no residual equinus in the hindfoot, a clear valgus position of the calcaneus, no residual internal rotation in the hindfoot and a fully restorable adduction of the forefoot by slight pressure on the medial side of the first metatarsal. A residual deformity of one of these criteria was considered to be a failure and resulted in a decision for operative treatment. Correction was obtained in 43 patients (95.5%), with 2 to 10 casts, with minimal complications. In conclusion, the Ponseti method is a very safe, efficient treatment for correction of clubfeet that radically decreases the need for extensive surgery