Outcome of Ponseti Technique in Children with Congenital Talipes Equinovarus: A Quasi-Experimental Trial

Background: Idiopathic congenital talipes equinovarus (CTEV), also known as clubfoot, is a developmental disorder of the limb. This study was done to determine the outcomes of CTEV following the Ponseti technique in terms of change in Pirani score in children presenting at a tertiary care hospital...

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Main Authors: Pervez Ali, Kashif Mehmood, M. Aslam Mengal, Shazia Soomro, Abdul Ghaffar, Sharjeel Khan, Mehtab Ahmed
Format: Article
Language:English
Published: ziauddin University 2025-07-01
Series:Pakistan Journal of Medicine and Dentistry
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Online Access:https://ojs.zu.edu.pk/pjmd/article/view/3578
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author Pervez Ali
Kashif Mehmood
M. Aslam Mengal
Shazia Soomro
Abdul Ghaffar
Sharjeel Khan
Mehtab Ahmed
author_facet Pervez Ali
Kashif Mehmood
M. Aslam Mengal
Shazia Soomro
Abdul Ghaffar
Sharjeel Khan
Mehtab Ahmed
author_sort Pervez Ali
collection DOAJ
description Background: Idiopathic congenital talipes equinovarus (CTEV), also known as clubfoot, is a developmental disorder of the limb. This study was done to determine the outcomes of CTEV following the Ponseti technique in terms of change in Pirani score in children presenting at a tertiary care hospital of a developing country. Methods: This quasi-experimental study was conducted in Jinnah Postgraduate Medical Center, Karachi, Pakistan, from 15th February 2023 to 30th December 2024. A total of 133 children aged 1 week to 2 years, having  CTEV (Pirani score 3-6), and undergoing Ponseti treatment were analyzed. Non-probability consecutive sampling technique was employed. All children underwent corrective sequential castings with manipulation as per the Ponseti method. Patients were followed up for 12 weeks, and the Pirani score was assessed. Wilcoxon Rank test, Mann-Whitney U test, Kruskal-Wallis test, and bivariate correlational analysis were applied (as appropriate), taking p<0.05 as significant. Data analysis was performed using IBM-SPSS Statistics, version 26.0. Results: In a total of 133 children,  101 (75.9%) were male. The median age was 2.00 (1.00-5.00) months. The median number of follow-up visits was 6.00 (6.00-8.00). Age distribution had having significant association with baseline Pirani score  (p=0.002). The median baseline and final follow-up (12 weeks) Pirani score were 5.00 (4.00-6.00) and 0.50 (0.00-1.00), p<0.001. Post-treatment (at 12 weeks), the Pirani score was significantly higher among children who underwent percutaneous tenotomy (p<0.001). Relatively modest, but significant positive association of final Pirani score with number of follow-up visits (r=0.238, p=0.002). Conclusion: The Ponseti technique is an effective and minimally invasive approach for managing CTEV in children, leading to significant improvement in Pirani scores over 12 weeks.
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spelling doaj-art-d53e1d9e14f44d7699d09ab05b8757b62025-08-20T03:51:29Zengziauddin UniversityPakistan Journal of Medicine and Dentistry2313-73712308-25932025-07-0114310.36283//ziun-pjmd14-3/013Outcome of Ponseti Technique in Children with Congenital Talipes Equinovarus: A Quasi-Experimental TrialPervez Ali0Kashif Mehmood1M. Aslam Mengal2Shazia Soomro3Abdul Ghaffar4Sharjeel Khan5Mehtab Ahmed6Department of Orthopedic Surgery, Jinnah Postgraduate Medical Center, KarachiDepartment of Orthopedic Surgery, Jinnah Postgraduate Medical Center, KarachiDepartment of Orthopedic Surgery, Sheikh Zaid Hospital, QuettaDepartment of Pediatric Medicine, National Institute of Child Health, KarachiDepartment of Orthopedic Surgery, Jinnah Postgraduate Medical Center, KarachiDepartment of Orthopedic Surgery, Jinnah Postgraduate Medical Center, KarachiDepartment of Orthopedic Surgery, Jinnah Postgraduate Medical Center, Karachi Background: Idiopathic congenital talipes equinovarus (CTEV), also known as clubfoot, is a developmental disorder of the limb. This study was done to determine the outcomes of CTEV following the Ponseti technique in terms of change in Pirani score in children presenting at a tertiary care hospital of a developing country. Methods: This quasi-experimental study was conducted in Jinnah Postgraduate Medical Center, Karachi, Pakistan, from 15th February 2023 to 30th December 2024. A total of 133 children aged 1 week to 2 years, having  CTEV (Pirani score 3-6), and undergoing Ponseti treatment were analyzed. Non-probability consecutive sampling technique was employed. All children underwent corrective sequential castings with manipulation as per the Ponseti method. Patients were followed up for 12 weeks, and the Pirani score was assessed. Wilcoxon Rank test, Mann-Whitney U test, Kruskal-Wallis test, and bivariate correlational analysis were applied (as appropriate), taking p<0.05 as significant. Data analysis was performed using IBM-SPSS Statistics, version 26.0. Results: In a total of 133 children,  101 (75.9%) were male. The median age was 2.00 (1.00-5.00) months. The median number of follow-up visits was 6.00 (6.00-8.00). Age distribution had having significant association with baseline Pirani score  (p=0.002). The median baseline and final follow-up (12 weeks) Pirani score were 5.00 (4.00-6.00) and 0.50 (0.00-1.00), p<0.001. Post-treatment (at 12 weeks), the Pirani score was significantly higher among children who underwent percutaneous tenotomy (p<0.001). Relatively modest, but significant positive association of final Pirani score with number of follow-up visits (r=0.238, p=0.002). Conclusion: The Ponseti technique is an effective and minimally invasive approach for managing CTEV in children, leading to significant improvement in Pirani scores over 12 weeks. https://ojs.zu.edu.pk/pjmd/article/view/3578ongenital talipes equinovarusfollow-upPirani scorePonseti techniquetenotomy
spellingShingle Pervez Ali
Kashif Mehmood
M. Aslam Mengal
Shazia Soomro
Abdul Ghaffar
Sharjeel Khan
Mehtab Ahmed
Outcome of Ponseti Technique in Children with Congenital Talipes Equinovarus: A Quasi-Experimental Trial
Pakistan Journal of Medicine and Dentistry
ongenital talipes equinovarus
follow-up
Pirani score
Ponseti technique
tenotomy
title Outcome of Ponseti Technique in Children with Congenital Talipes Equinovarus: A Quasi-Experimental Trial
title_full Outcome of Ponseti Technique in Children with Congenital Talipes Equinovarus: A Quasi-Experimental Trial
title_fullStr Outcome of Ponseti Technique in Children with Congenital Talipes Equinovarus: A Quasi-Experimental Trial
title_full_unstemmed Outcome of Ponseti Technique in Children with Congenital Talipes Equinovarus: A Quasi-Experimental Trial
title_short Outcome of Ponseti Technique in Children with Congenital Talipes Equinovarus: A Quasi-Experimental Trial
title_sort outcome of ponseti technique in children with congenital talipes equinovarus a quasi experimental trial
topic ongenital talipes equinovarus
follow-up
Pirani score
Ponseti technique
tenotomy
url https://ojs.zu.edu.pk/pjmd/article/view/3578
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