Original Article- Comparative Study of Functional Outcome of Idiopathic Congenital Talipes Equinovarus Treated between Ponseti Technique and Accelerated Ponseti Technique using Pirani Score
Background and Objectives: Congenital talipes equinovarus (CTEV), also known as clubfoot, is one of the most prevalent
birth disorders affecting the musculoskeletal system and affects one in 1000 live births. The tried-and-true Ponseti method of
therapy entails weekly adjustment of the deformity followed by a long-leg cast. Modified accelerated treatment protocols were
designed to reduce the total duration of treatment. This study was conducted to compare the efficacy of accelerated Ponseti
method versus standard Ponseti method. Methods: A randomized controlled study was conducted with participants randomized
to two groups-Study group and Control groups. All feet were scored using Pirani score, recorded by an independent assessor at
each visit. Plaster treatment was continued until clinical correction achieved. Results: The study had 100% subject retention in
both the groups from baseline to follow-up. The current study had comparable demographic distribution between the groups.
Accelerated Ponseti technique has relatively shorter duration of manipulation compared to the standard Ponseti technique.
Total number of casts used is not significantly different for accelerated Ponseti technique compared to the standard Ponseti
technique. Accelerated Ponseti technique for club foot management was found to be equally effective compared to the standard
Ponseti technique in managing idiopathic CTEV assessed by Pirani scoring. Interpretation and Conclusion: According to
the best evidence synthesis, no evidence exists to support the use of a cast change interval of 1 week. It can be concluded that
the accelerated versions of the Ponseti method can safely be used in the treatment of clubfoot without risking any significant
increase in the required number of casts.