Abstract
Introduction: The management of idiopathic talipes equino varus remains controversial. Excellent long term results have been reported with non operative management using the Ponseti technique.
Aim: To assess prospectively the early radiologic and clinical results in idiopathic club feet treated in New Zealand by the Ponseti technique.
Method: We have reviewed prospectively 29 feet in 19 consecutive patients presenting with idiopathic club feet. The initial assessment consisted of a clinical examination, assessment of the Pirani score and clinical photographs. At follow-up the Pirani score, ankle range of motion, foot length and calf circumference were measured and radiographs were taken. Follow-up was at an average age of 7.3 months.
Results: The Pirani score improved from an average of 4.9 to 0.5. The range of motion averaged 32 degrees dorsiflexion and 42 degrees plantar flexion. Radiographs showed good correction of the hindfoot with a mean talocalcaneal index of 55 degrees, and a dorsiflexion tibiocalcaneal angle of 62 degrees. A normal mean AP talo-first metatarsal, AP calcaneo-fifth metatarsal angle, and lateral talo-first metatarsal angle showed good correction of midfoot adductus and cavus. Forced dorsiflexion radiographs showed that ⅗ ths of dorsiflexion motion occurred in the hindfoot and ⅖ ths in the midfoot. Complications were all minor. One non-compliant patient required bilateral posteromedial releases.
Conclusions: This is the largest reported series outside of Iowa City using this technique and the first to show the early radiographic findings. Excellent early clinical and radiographic results have been shown.
The abstracts were prepared by Professor A. J. Thurston. Correspondence should be addressed to him at the Department of Surgery, Wellington School of Medicine, PO Box 7343, Wellington South, New Zealand
