Treatment options for congenital clubfoot in children

Purpose of a study: to evaluate the effectiveness and confirm the status of the Ponseti method as the gold standard of conservative treatment of congenital clubfoot in young children based on 10 years of experience in the Department of Pediatric Orthopedics, the Emergency Hospital No. 2 (Tomsk, Russia). Material and methods . Over the past 10 years, 168 children aged 1 month to 3 years with congenital clubfoot (198 feet) have been treated at the Department of Pediatric Orthopedics, the Emergency Hospital No. 2 in Tomsk. The degree of congenital deformity before treatment was assessed according to the A. Dimeglio school. It ranged from 15 to 20 points. 168 achilotomies were performed during this treatment period. To eliminate foot deformity, plaster bandages were applied from the tips of the toes to the upper third of the thigh in the bent knee joint, plaster bandages were changed after 7–10 days, and 4–8 casts were required to completely eliminate clubfoot and the treatment period ranged from 4 to 6 weeks, depending on the rigidity of the deformity. At the final stage, after the plaster cast, the children were prescribed braces with the foot held in a 60–70° abduction position and a back flexion of 15°. It is necessary to note the features of wearing braces, that for the first 4 months it was recommended to wear them around the clock, then the time of wearing braces was shifted to the period of daytime and night sleep. Results . The results of treatment of 88 children with congenital clubfoot (129 feet) aged 3 months to 3 years were studied and evaluated according to a 4-point system: excellent 65 children (73.86%), good 11 (12.5%), satisfactory 8 (9.09%), unsatisfactory 4 (4.55%). Conclusion . The I. Ponseti method of treating children with congenital clubfoot can be considered as the gold standard. The technique itself is simple and highly effective for correcting congenital clubfoot and makes it possible to correct this deformity.