Ubaid Ullah U1
1Khyber Medical University, MCP-Physiotherapy Department, Peshawar, Pakistan
Background: Club foot deformity is a common congenital problem caused by abnormal development of bones, ligaments and muscles of the baby in the uterus. By medical point of view it is characterized by calf muscle atrophy, Varus of hind foot, Ccavus and Adductus of fore foot and Equinus of the ankle. It can cause life time disability pain and difficulty in walking if remained untreated. The socioeconomic consequences may include lack of access to education, employment and acceptance in the society. Clubfoot is widely managed through Ponseti technique by variety of healthcare professionals like Physiotherapists, Prosthetists & Orthotists and orthopedic surgeons.
Purpose: The primary purpose of this study was to review the effectiveness of Ponseti technique in a multidisciplinary clubfoot clinic at Lady Reading Hospital Peshawar. The secondary purpose of this study was to strengthen the evidence of the effectiveness of physiotherapist-delivered Ponseti services in collaboration with orthopedic team.
Methods: This was a retrospective notes audit conducted from 1st August 2017 to 31st January 2018 on 163 idiopathic clubfoot children enrolled in clubfoot clinic. The Ponseti technique was used in these Children followed by small surgical procedure name as tenotomy in most of the cases to achieve full range of dorsi flexion (DF) and later the Dennis Brown Splint (DBS) and exercises for maintenance of normal ranges of foot movements. The Pirani scoring chart was used for initial and follow up assessment.
Results: About 66% of study population was aged from 0-6 month, males children were more as compared to females (69% vs. 30%) and most of the cases were bilateral (69%). Most of the CF children (84%) received serial casts ranging from 0-6 times and tenotomy was performed for about 70% children. The paired sample t-test reported significant difference on Pirani scores (P =0.000) for both the feet, which shows the clinical significance of the Ponseti techniques for club foot patients.
Conclusion(s): The Ponseti technique is clinically significant and effective in managing patients if followed properly with idiopathic club foot, across any age from 0-24 months. Ponseti technique is effective for both male and female with different Perani scoring outcomes.
Implications: This study will make physiotherapist confident in running club foot clinics and will spark a ray a hope in families who are availing physiotherapist based Ponseti services.
Keywords: Clubfoot, Pirani scoring, Ponseti technique
Funding acknowledgements: For the support to proceed this study we are thankful to LRH-MTI and ICRC for sponsoring the treatment of children.
Purpose: The primary purpose of this study was to review the effectiveness of Ponseti technique in a multidisciplinary clubfoot clinic at Lady Reading Hospital Peshawar. The secondary purpose of this study was to strengthen the evidence of the effectiveness of physiotherapist-delivered Ponseti services in collaboration with orthopedic team.
Methods: This was a retrospective notes audit conducted from 1st August 2017 to 31st January 2018 on 163 idiopathic clubfoot children enrolled in clubfoot clinic. The Ponseti technique was used in these Children followed by small surgical procedure name as tenotomy in most of the cases to achieve full range of dorsi flexion (DF) and later the Dennis Brown Splint (DBS) and exercises for maintenance of normal ranges of foot movements. The Pirani scoring chart was used for initial and follow up assessment.
Results: About 66% of study population was aged from 0-6 month, males children were more as compared to females (69% vs. 30%) and most of the cases were bilateral (69%). Most of the CF children (84%) received serial casts ranging from 0-6 times and tenotomy was performed for about 70% children. The paired sample t-test reported significant difference on Pirani scores (P =0.000) for both the feet, which shows the clinical significance of the Ponseti techniques for club foot patients.
Conclusion(s): The Ponseti technique is clinically significant and effective in managing patients if followed properly with idiopathic club foot, across any age from 0-24 months. Ponseti technique is effective for both male and female with different Perani scoring outcomes.
Implications: This study will make physiotherapist confident in running club foot clinics and will spark a ray a hope in families who are availing physiotherapist based Ponseti services.
Keywords: Clubfoot, Pirani scoring, Ponseti technique
Funding acknowledgements: For the support to proceed this study we are thankful to LRH-MTI and ICRC for sponsoring the treatment of children.
Topic: Disability & rehabilitation
Ethics approval required: Yes
Institution: MCP
Ethics committee: IRRC
Ethics number: 66/MCP/18
All authors, affiliations and abstracts have been published as submitted.
