The Ponseti Method for the Management of CTEV – 10 year Results
Presented in National Medical Students Paediatric Conference (NMSPC) 2014, Brighton, UK
Tiffany Keep
University of Bristol, UK
Abstract
Congenital Talipes Equinovarus (CTEV), or clubfoot, is a common musculoskeletal condition, affecting 1 in 1000 live births in the UK. The ratio of males to females is roughly 2:1, and approximately 50% of cases are bilateral. CTEV is a developmental deformity which occurs during the second trimester of pregnancy, with currently unknown etiology.

In 1963, Ponseti reported his method for treating CTEV at The State University of Iowa. His aim was ‘to obtain a supple, well corrected foot in the shortest possible time’, which could be achieved by manipulation using the talus as the fulcrum for abduction, avoiding the need for extensive surgery.

This case series has collected data from 156 patients (231 clubfeet) in Maidstone Hospital in a physiotherapist run clinic from 2002 to 2012. The clinic aims to resolve clubfeet to a Pirani score of 0. This project aimed to review the effectiveness of the Ponseti method of treatment in Maidstone Hospital by evaluating the initial Pirani score (5), the mean number of manipulative casts required per foot (8.3), the percentage of relapse into plaster or additional plaster casts required (32%), the percentage of patients who required a tenotomy (58%) and the percentage of patients who required further surgery (3%). These figures were then compared to figures from other Ponseti Clinics from around the world.
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