Accelerated method of casting for correction of clubfoot applicable?

Abstract

Objective: To see the results of accelerated method against standard Ponseti method for correction of clubfoot by using Pirani scoring system. Study Design: Randomized controlled trial. Setting: Children’s hospital and the institute of child’s health, Lahore. Period: June 2019 Dec 2019. Material & Method: 100 patients included in this study and divided into two groups. In group A (50 patients) correction was done by standard Ponseti method while accelerated method was applied in group B(50 patients). Weekly serial casting was done in group A while twice weekly in group B. Assessment was done by Pirani scoring system in both groups at beginning of correction, at each cast and at end of correction. Results: Average casting time for group A was 38 days while it was 20 days in group B. Correction rate was 94% in group A and 89% in group B. This difference was not found to be statistically significant (p=0.396). Conclusion: Accelerated method is applicable for correction of clubfoot because treatment time is shorter and results are similar to standard Ponseti method. Hence, this method should be adopted in Pakistan so that poor and rural parents can easily manage travel and financial issues because only 2 to 3 weeks are required for whole casting treatment.