Early Management of Clubfoot by the Ponseti Method with Complete Percutaneous Tenotomy of Tendoachillis

Background And Objective: As a highly common congenital deformity which can lead to serious walking problems, clubfoot has long been treated using the Ponseti method which is usually carried out without complete percutaneous tenotomy of tendoachillis. The present study was aimed at investigating the effects of early management of clubfoot by the Ponseti method with a complete percutaneous tenotomy of tendoachillis in Erbil Teaching Hospital located in Erbil, the Kurdistan Region of Iraq.

Methods: Thirty neonates <3 months of age who had congenital idiopathic clubfoot were randomly selected. They were treated by the Ponseti method. For this purpose, successive casts were applied for them for 3 weeks, with changing the casts on a weekly basis. For those who did not respond to the first 3 weeks of casting, the classical Ponseti method was utilized along with complete percutaneous tenotomy of tendoachillis based on the theory of stem cell regeneration. Then, the casting was performed for 6 weeks, followed by foot abduction brace and maintained using a foot abduction brace (Dennis brown splint) until school age 5-6 years. The collected data were analyzed using the χ test through SPSS 22.0.

Results: The results of the present study indicated that the most prevalent type of clubfoot was the unilateral type with 73.3% prevalence rate. Treating the newborns with clubfoot by the Ponseti method along with complete percutaneous tenotomy of tendoachillis led to good results in 86.7% of the cases, medium in 3 cases (10%), and poor only in 1 case (3.3%).

Conclusion: Ponseti method along with complete percutaneous tenotomy of tendoachillis was proved to be an efficient method to treat clubfoot during the first few weeks of life.