Management of complex idiopathic clubfoot using modified Ponseti method

Clubfeet with rigid equinus, severe plantarflexion of all the metatarsals, a transverse crease in sole foot, short and hyperextended great toe, forefoot adduction supination deep posterior are categorized under heading complex clubfeet, which do not respond to conventional Ponseti technique. Rather treatment such feet method results development secondary deformities thus failure treatment. Hence modification technique is warranted for optimal correction these as described by Ponseti. The aim our study was evaluate effectiveness Modified management clubfoot. Thirty two clubfeet 19 patients were managed through period. Four 7 lost follow-up. At end 15 25 available final follow up assessment evaluation. Pirani Dimeglio score allotted each foot at every visit. There after manipulated casted per an interval one week. Average number casts required deformity 7.68. Tendo-achilles tenotomy obligatory 23 (93.33 %) feet. mean follow-up duration 12.35 months (Range 8-21 months). pre-treatment (initial PS) 5.60±0.54 post-treatment (PS SFAB) 0.70±0.38. change post intervention found be statistically significant. DS) 15.80±2.02 (DS 3.68±1.35. Relapse rate 4% (n=1), responded re-casting modified re-tenotomy tendo-achilles. Based on existing literature we recommend first line initial However require higher plaster tendo-achilles tenotomy, high relapse than their classical idiopathic counterparts, nonetheless eventual outcome reasonable deformity, negating necessity multifaceted operating procedures.