The Problems Encountered in a CTEV Clinic: Can Better Casting and Bracing Be Accomplished?

BACKGROUND

The aim of the study is to create awareness in the practicing health care workers toward the problems encountered during casting and bracing of clubfoot following Ponseti method, and in turn avoid them.

MATERIAL AND PATIENTS: Retrospective audit of 6 years' clubfoot clinic records to analyze problems associated with Ponseti method.

OBSERVATIONS: Problems were encountered in 26 cast and in 6 braced patients. Just 4 patients out of 71 syndromic (5.6%) experienced problems during casting compared with 3% overall incidence. The common problems encountered in casted patients were moisture lesions, hematoma, dermatitis due to occlusion, pressure sores, and fractures. There was excessive bleeding in 1 patient at time of tenotomy. In braced patients, pressure sores and tenderness at tenotomy site were major problems. None of the syndromic patients experienced difficulties during bracing.

CONCLUSIONS

Problems were encountered with Ponseti method during casting, tenotomy, or bracing. Syndromic children had lesser complication rate than idiopathic clubfeet. It is important to be aware of these problems so that appropriate intervention can be done early.

LEVELS OF EVIDENCE: Level IV: Retrospective.