On-line version ISSN 2309-8309
SA orthop. j. vol.8 n.4 Pretoria Jan. 2009
GB FirthI; M EltringhamII; IIIG ShnierIII
IMBBCh, FCS(SA)Orth, MMed(Rand)(Orth); Consultant Orthopaedic Surgeon, Chris Hani Baragwanath Hospital. Division of Orthopaedic Surgery, University of the Witwatersrand, Johannesburg
IIMBBCh, FCS(SA)(Orth); Consultant Orthopaedic Surgeon, Sunninghill Hospital. Division of Orthopaedic Surgery, University of the Witwatersrand, Johannesburg
IIIHN Dip Med Proth Orth (Tut SA), Honours(Med Proth Orth)(Tut SA); Orthotist Prosthetist , Sunninghill Hospital. Division of Orthopaedic Surgery, University of the Witwatersrand, Johannesburg
An audit was performed at a South African clinic in an attempt to compare results with those already published internationally. The aim was to determine the outcome and need for further surgery using this technique. A retrospective review was performed of a single surgeon practice using the Ponseti technique on all patients presenting with a clubfoot deformity.
Patients with less than one year of final follow-up were excluded. A total of 70 patients were reviewed (106 feet). Patients were seen at a mean age of 3 months and 20 days. A mean of 6.5 casts were applied. The Achilles tenotomy rate was 74% (78 feet). A good outcome with complete correction was achieved in 63 feet (59%). Overall recurrence requiring re-plastering occurred in 24 feet (23%) and further surgery (other than Achilles tenotomy) was required in seven feet (7%).
The Ponseti technique is a successful and rewarding method of treating all children with clubfeet. The technique must be done according to Ponseti's principles with attention to detail, rigorous parent education and close follow-up. Prior treatment was not associated with a worse outcome. Greater awareness and education regarding the Ponseti technique is mandatory to ensure early successful treatment.
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Dr GB Firth
Dept of Orthopaedics
Wits Medical School
Tel: (011) 717-2538; Fax: (011) 717-2551
This article is the sole work of the authors. No benefits of any form are to be received from a commercial party related directly or indirectly to the subject of this article.