Treatment of idiopathic congenital clubfoot using the Ponseti method: ten years of experience.

OBJECTIVE

To evaluate outcomes of 229 idiopathic clubfeet (ICF) treated using the Ponseti method, from 2001 to 2011, comparing two groups with different follow-ups.

METHOD: 155 patients (229 ICF) were treated separated in two groups: Group I: 72 patients (109 ICF - 47.6%) with a follow up of 62 to 128 months (mean of 85). Group II: 83 patients (120 ICF - 52.4%) with a follow up of 4 to 57 months (mean of 33.5). We have considered satisfactory outcomes for cases which correction of all deformed components, without surgery.

RESULTS

Mean age for the initial assessment was 5.4 months in Group I and 3.2 in Group II. Satisfactory outcomes were obtained in 85.4% in Group I and 97.5% in Group II. Mean cast placements were 9.5 in Group I and 7 in Group II. 67% were submitted to percutaneous Achilles tenotomy in Group I and 65% in Group II. Deformity relapses, when using abducted braces, occurred in 41 (37.6%) feet from Group I; 11 were treated surgically. In Group II, 17 feet relapsed (14.1%); three of them were submitted to surgery.

CONCLUSION

The method was successful in both groups, in low number of complications. The results were statistically superior in Group II when deformity correction, cast placements, relapses and surgery indication.