EFFECTIVENESS OF PRE-CASTING STRECHING IN PONSETI METHOD OF CLUB FOOT MANAGEMENT.
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Keywords
Congenital clubfoot; Ponseti method; Pre-casting stretching; Pediatric orthopedics
Abstract
Background: Congenital clubfoot is among the most frequent forms of pediatric musculoskeletal deformities, and if left untreated, results in lifelong disability. The most effective treatment is the Ponseti method, where high rates of correction are achieved via serial castings. Nevertheless, there are differences in the total number of casts needed and in the duration of the treatment. To improve the pliability of the soft tissues so that a quicker correction of the deformities and better results of the treatment can be achieved, pre-casting stretching procedures have been suggested as a method of treatment.
Objectives: to analyses the efficacy of pre-casting stretching on improvement of clinical outcomes, reduction of casting requirements, and faster initial clinical improvement of infants using the Ponseti method for the treatment of Congenital Clubfoot.
Methodology: A prospective study focused on 100 babies suffering from idiopathic congenital clubfoot and was conducted on a comparative basis. The study participants were split into two groups. The first group was treated using the Ponseti technique in conjunction with pre-casting stretching, while the second group was treated with the Ponseti technique in isolation. Stretching was done before each cast was put on. The outcomes of interest were the degree of deformity correction, frequency of casts used, and whether there was a need for percutaneous Achilles tenotomy.
Results: The study population had a mean age of 3.2 ± 1.4 months at presentation. Infants receiving pre-casting stretching demonstrated faster correction and required fewer casts compared to the control group. Improvement in correction milestones was observed earlier in the stretching group. Statistical analysis showed a significant difference in treatment outcomes between groups (p < 0.05). Baseline demographic variables were comparable, indicating minimal confounding.
Conclusion: Inserting pre-casting stretching as an adjunct to the Ponseti technique is effective. As this is a low-risk manoeuvre, if started early, it can minimise casting burden, expediting corrections and improving overall treatment efficiency.
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Irfan Ullah
Consultant Orthopedics, Khalifa Gulnawaz Hospital Bannu Pakistan
Asif Aziz
Trainee Registrar, KGN Hospital Bannu Pakistan
Sehrish Gul
Trainee General Surgery, Khalifa Gulnawaz Teaching Hospital Pakistan
Muhammad Usman
Casualty Medical Officer, KGN Teaching Hospital MTI Bannu Pakistan
Muhammad Saqib Ullah
Medical Officer, KGN Teaching Hospital, MTI Bannu Pakistan
Alam Zeb
Professor & HOD Orthopedics, Khalifa Gul Nawaz Hospital Bannu Pakistan
