Treatment of idiopathic congenital clubfoot using the Ponseti method: ten years of experience()

OBJECTIVE: To evaluate outcomes of 229 idiopathic clubfeet (ICF) treated using the Ponseti method, from 2001 to 2011, comparing two groups with different follow-ups. METHOD: 155 patients (229 ICF) were treated separated in two groups: Group I: 72 patients (109 ICF – 47.6%) with a follow up of 62 to 128 months (mean of 85). Group II: 83 patients (120 ICF – 52.4%) with a follow up of 4 to 57 months (mean of 33.5). We have considered satisfactory outcomes for cases which correction of all deformed components, without surgery. RESULTS: Mean age for the initial assessment was 5.4 months in Group I and 3.2 in Group II. Satisfactory outcomes were obtained in 85.4% in Group I and 97.5% in Group II. Mean cast placements were 9.5 in Group I and 7 in Group II. 67% were submitted to percutaneous Achilles tenotomy in Group I and 65% in Group II. Deformity relapses, when using abducted braces, occurred in 41 (37.6%) feet from Group I; 11 were treated surgically. In Group II, 17 feet relapsed (14.1%); three of them were submitted to surgery. CONCLUSION: The method was successful in both groups, in low number of complications. The results were statistically superior in Group II when deformity correction, cast placements, relapses and surgery indication.