Clubfoot management by the Ponseti technique in Saudi patients

OBJECTIVE: To assess the effectiveness of the Ponseti technique in the treatment of clubfoot in Saudi children.

METHODS: The data of 175 patients (235 feet), who presented with clubfeet from September 2002 to June 2008 and who were treated with the Ponseti technique at King Abdulaziz Medical City in Riyadh, Kingdom of Saudi Arabia were collected and studied retrospectively. The Pirani score for clubfoot evaluation was used in this study.

RESULTS: Age ranged from one week to 48 weeks, with an average age of 6.5 weeks. The average follow up was 37 months (range one year to 6 years and 7 months). The average time to obtain correction was 5.3 weeks (range 4-10 weeks). Six patients (8 feet) (3.4%) were not corrected with initial casting and required early surgery. Full correction was obtained in 169 patients (227 feet) (96.6%). Tenotomies were performed in all but one patient (2 feet) (0.9%). Thirty-four patients (48 feet) (21.1%) relapsed. One hundred and seventy-nine feet (78.9%) required no further treatment, and only 4 feet (1.8%) required a more extensive posterior-medial release. Minor complications were noted in 14 patients (18 feet) (7.9%).

CONCLUSION: The Ponseti technique is a safe and effective conservative treatment of clubfoot that decreases the number of surgical interventions needed for the correction of the deformation in our Saudi patients. It is an easy method to understand and to apply by most orthopedic surgeons.