[go: up one dir, main page]
More Web Proxy on the site http://driver.im/
Skip to main content
Springer Nature Link
Log in

Ponseti’s vs. Kite’s method in the treatment of clubfoot-a prospective randomised study

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Ponseti’s and Kite’s methods of conservative management in idiopathic congenital clubfoot were compared in a prospective randomised study consisting of 45 infants (67 feet) younger than 3 months, from March 2003 through February 2004. There were 36 and 31 feet that underwent treatment by Ponseti’s and Kite’s methods, respectively. After an average follow-up of 27.24 months in the Ponseti group, correction was achieved in 33 feet (91.7%), with only three patients requiring surgical management. There were seven relapses (21.1%), all of which were corrected conservatively. However, two of these required surgical intervention on showing a relapse again in the second year. In the Kite group, we achieved correction in 21 feet (67.7%) after an average follow-up of 24.8 months, with ten patients requiring surgical intervention. There were eight relapses of which only four could be corrected conservatively. We could also achieve correction in very severe feet (Dimeglio classification) in a significantly higher percentage using Ponseti’s method, in significantly lesser time and with fewer casts. We are of the opinion that Ponseti’s method is superior to Kite’s method in achieving correction in idiopathic clubfeet in a relatively shorter period of time when used to treat young infants.

Résumé

Les méthodes de Ponseti et de Kite dans le traitement conservateur du pied bot congénital sont comparées dans une étude prospective randomisée incluant 45 enfants (67 pieds), traités avant 3 mois, étude réalisée de mars 2003 à février 2004. Trente-six pieds ont été traités selon la méthode de Ponseti et 31 selon la méthode de Kite. Le suivi moyen a été de 27.24 mois dans le groupe de Ponseti. La correction a été réalisée dans 33 pieds (91.7%), seulement 3 patients ont nécessité un traitement chirurgical. Il y a eu 7 récidives (21.1%), tous les pieds ont été traités avec un traitement conservateur. Cependant deux pieds nécessitant un traitement chirurgical ont montré une récidive dans la deuxième année. Dans le groupe Kite, la correction a été réalisée dans 21 pieds (67.7%) avec un suivi moyen de 24.8 mois, 10 patients ont nécessité un traitement chirurgical et 8 récidives dont 4 ont bénéficié d’un traitement conservateur. Nous pouvons traiter les pieds sévères (classification de Dimeglio) avec un bon pourcentage et bon résultat en utilisant la méthode de Ponseti qui permet de diminuer le temps de traitement et le nombre de plâtre. Nous pouvons conclure que la méthode de Ponseti est supérieure à la méthode de Kite, elle permet un temps de traitement plus court dans le traitement des pieds bots varus équins de l’enfant.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
£29.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (United Kingdom)

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Aronson J, Puskarich CL (1990) Deformities and disabilities from treated club foot. J Pediatr Orthop 10(1):109–119

    PubMed  CAS  Google Scholar 

  2. Cooper DM, Dietz FR (1995) Treatment of idiopathic clubfoot-a 30-year follow-up note. J Bone Joint Surg 77-A(10):1477–1489

    Google Scholar 

  3. Cummings RJ (2002) Letter to editor. J Bone Joint Surg 84-A(10):1890

    Google Scholar 

  4. Demeglio A, Bensahel H, Sanchet P et al (1985) Classification of clubfoot. J Pediatr Orthop (B) 4:129–136

    Google Scholar 

  5. McKay DW (1982) New concept of approach to clubfoot treatment. Section 1-Principles and morbid anatomy. J Pediatr Orthop 2(4):347–356

    PubMed  CAS  Google Scholar 

  6. Herzenberg JE, Radler C, Bor N (2002) Ponseti versus traditional method of casting for idiopathic club foot. J Pediatr Orthop 22(4):517–520

    Article  PubMed  Google Scholar 

  7. Ippolito E, Farsetti P, Caterini R, Tudisco C (2003) Long-term comparative results in patients with congenital clubfoot treated with two different protocols. J Bone Joint Surg 85 A(7):1286–1294

    PubMed  Google Scholar 

  8. Herring JA (ed) ( 2002) Congenital talipes equinovarus (clubfoot) in Tachdjian’s paediatric orthopaedics, vol. 2, 3rd edn. Philadelphia, Saunders p 927

    Google Scholar 

  9. Kite JH (1935) The treatment of congenital clubfoot. Surg Gynaecol Obstet 61:190–200

    Google Scholar 

  10. Kite JH (1939) Principles involved in the treatment of congenital clubfoot. J Bone Joint Surg 21:595–606

    Google Scholar 

  11. Kite JH (1972) Non operative treatment of congenital clubfoot. Clin Orthop 84:29–38

    Article  PubMed  CAS  Google Scholar 

  12. Laaveg SJ, Ponseti IV (1980) Long-term results of treatment of congenital clubfoot. J Bone Joint Surg 62-A:23–31

    Google Scholar 

  13. Lehman WB, Mohaideen A, Madan S, Scher DM, Van Bosse HJ, Iannacone M, Bazzi JS, Feldman DS (2003) A method for the early evaluation of the Ponseti (Iowa) technique for treatment of idiopathic clubfoot. J Pediatr Orthop (B) 12:133–140

    Article  PubMed  Google Scholar 

  14. Morceunde JA, Dolan LA, Dietz FR, Ponseti IV (2004) Radical reduction in therate of extensive corrective surgery for clubfoot using the Ponseti method. Pediatrics 113:376–380

    Article  Google Scholar 

  15. Morceunde JA, Abbasi D, LA Dolan, Ponseti IV (2005) Results of an accelerated Ponseti protocol for club foot. J Pediatr Orthop 25(5):623–626

    Article  Google Scholar 

  16. Nather A, Bose K (1987) Conservative and surgical treatment of clubfoot. J Pediatr Orthop 7(1):42–48

    PubMed  CAS  Google Scholar 

  17. Pirani S, Zeznik L, Hodges D (2001) MRI study of congenital clubfoot treated with Ponseti method. J Pediatr Orthop 21(6):719–726

    Article  PubMed  CAS  Google Scholar 

  18. Ponseti IV (1992) Current concept review. Treatment of congenital club foot. J Bone Joint Surg 74 A(3):448–454

    Google Scholar 

  19. Ponseti IV (1996) Treatment. Congenital clubfoot-fundamentals of treatment. New York; Oxford University Press pp 61–81

    Google Scholar 

  20. Ponseti IV (1997) Common Errors in the treatment of congenital clubfoot. Current Concepts, Int Orthop (SICOT) 21:137–141

    Article  CAS  Google Scholar 

  21. Ponseti IV (2000) Editorial club foot. J Pediatr Orthop 20(6):699–700

    PubMed  CAS  Google Scholar 

  22. Scher DM (2006) The Ponseti method of treatment of clubfoot. Curr Opin Pediatr 18(1):22–28

    PubMed  Google Scholar 

  23. Segev E, Keret D, Lokiec F, Yavor A, Wientroub S, Ezra E, Havek S (2005) Early experience with the Ponseti method for treatment of congenital idiopathic club foot. Isr Med Associ J 7(5):307–310

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Orthopaedics, Lady Hardinge Medical College, U-V/ 116 C, Block B, Shalimar Bagh, New Delhi, 110088, India

    Alok Sud, Akshay Tiwari, Deep Sharma & Sudhir Kapoor

Authors
  1. Alok Sud
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Akshay Tiwari
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Deep Sharma
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sudhir Kapoor
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alok Sud.

Additional information

The authors are grateful to Dr. Chandrakant Lahariya for his contribution in statistical analysis of the study.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sud, A., Tiwari, A., Sharma, D. et al. Ponseti’s vs. Kite’s method in the treatment of clubfoot-a prospective randomised study. International Orthopaedics (SICO 32, 409–413 (2008). https://doi.org/10.1007/s00264-007-0332-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-007-0332-y

Keywords

Search

Navigation