Study of Management of Congenital Talipes Equinovarus by Ponseti Method and Percutaneous Tenotomy

Abstract

Introduction: Congenital talipes equinovarus (CTEV) is a common congenital musculoskeletal deformity that can cause significant functional disability if untreated. The Ponseti method is widely accepted as the standard conservative treatment for idiopathic CTEV. Methods: This prospective observational study included 75 children with idiopathic CTEV (110 affected feet) treated at a tertiary-care centre in Western Gujarat. Patients underwent serial Ponseti manipulation and casting, with percutaneous Achilles tenotomy when indicated. Deformity severity and treatment response were assessed using the Pirani score, along with the number of casts, correction achieved, complications, and relapse during follow-up. Results: Most patients (84.0%) presented within the first three months of life; 62.7% were male and 46.6% had bilateral involvement. The mean initial Pirani score was 5.18 ± 0.58 and decreased significantly to 0.34 ± 0.41 after treatment (p < 0.001). The mean number of casts required was 6.84 ± 1.32, while Achilles tenotomy was performed in 83.6% of feet. A plantigrade foot was achieved in 96.4% of feet. During follow-up, 92.0% of patients maintained correction and relapse occurred in 8.0%. Conclusion: The Ponseti method is an effective and minimally invasive treatment for idiopathic CTEV, providing excellent correction with low complication and relapse rates. Keywords: CTEV; Ponseti method; Pirani score; Achilles tenotomy