STUDY OF COMPARISON OF THE RECURRENCE PATTERNS IN CTEV PATIENTS WITH ADHERENCE TO BRACE PROTOCOLAND THOSE WITHOUT ADHERENCE TO BRACE PROTOCOL IN CHILDREN UP TO 5 YEARS.

Abstract

BACKGROUND: The purpose of the study was to evaluate the comparative outcome of the recurrence pattern in congenital talipes equino varus (CTEV) patient’s upto 5 years old following Ponseti correction and brace application. METHODS: A study of prospectively collected cohort data of 94 newly diagnosed idiopathic CTEV patients who were managed conservatively with Ponseti correction followed by tendoachilles (TA) tenotomy in 90 % of patients and brace application. Patients were evaluated with Pirani scoring prior to commencing Ponseti correction and during follow up and the parents were asked regarding the compliance and acceptance of the brace by the child and the difficulties faced while the child was on brace. RESULT: Out of 94 patients in our study, recurrence of deformity was noticed in 13 patients, while 81 patients had totally normal functional foot. CONCLUSION: We conclude that the Ponseti method enables us to correct most clubfeet with gentle manipulation, casting and foot abduction brace. Experience with the Ponseti method and great attention to the details of manipulation and moulding of the cast are necessary to achieve initial correction rate of over 98%.