Clinico-radiological Outcome after Ponseti Technique for Bilateral Idiopathic Congenital Talipes Equinovarus

Aim and objective: Ponseti method is a well-established treatment method for clubfeet. It has been suggested that pooling of data for unilateral and bilateral idiopathic congenital talipes equinovarus (ICTEV) is not appropriate. Therefore, this study aimed to evaluate the clinical and radiological outcome and their correlation in bilateral clubfeet. Materials and methods: Thirty infants (19M:11F) with bilateral ICTEV underwent the Ponseti method of treatment. Pirani scores and X-rays were recorded at the first visit (pre-treatment) and at the end of 12 months (post-treatment). Radiological angles were measured on anteroposterior (AP) and lateral (Lat) views of the foot and ankle. Results: The mean age was 6.7 3.4 weeks (range 1-11 weeks). The mean initial Pirani score was 4.28 1.1 (left) and 4.23 1.09 (right). Successful outcomes were observed in 27/30 (90%) and 28/30 (93%) of the left and right foot, respectively. The mean number of casts required for left and right were (5.3 1.1) and (4.9 1.0), respectively. Achilles tendon (TA) tenotomy was performed in 76% (left) and 73% (right) feet. The postprocedure Pirani scores significantly correlated with talocalcaneal angle on AP (TCAP) and lateral views (TCL) on left (r AP = 0.63, r Lat = 0.76) and right feet (r AP = 0.65, r Lat = 0.73) (p < 0.01). Talocalcaneal index (TCI) has been significantly correlated with postprocedure Pirani score in left (r = 0.77) and right (r = 0.64) feet (p < 0.01). Tibiocalcaneal lateral angle (TiCL) has been significantly correlated with postprocedure Pirani score in the left feet (p < 0.01). Conclusion: Bilateral ICTEV can be treated successfully by the Ponseti method in infants. There was a good correlation between clinical scores and radiological parameters.