Factors affecting outcomes of congenital talipes equinovarus cases treated using the Ponseti method

Abstract

BACKGROUND: The Ponseti method is recognized worldwide as an effective, ubiquitous, and cost-effective approach for treating congenital talipes equinovarus (CTEV) and has been adopted by many countries. This study assessed factors that may affect the clinical outcome of CTEV patients treated with the Ponseti method, such as their age at presentation, comorbid disorders, classification, and adherence to therapy.METHODS: This observational study used a retrospective cohort study design. Its study population was all CTEV patients treated with the Ponseti method at Grestelina Hospital Makassar between 2006 and 2021. Clinical outcome after therapy was assessed using the Assessing Score Treatment (ACT) score. The relationships among study variables were determined using univariate and bivariate methods, considering a significance level of P<0.05.RESULTS: This study included 124 patients. Most patients were male (59.7%), first presented at 0-3 weeks of age (39.5%) with the rigid (flexible) type (84.7%), and had no comorbid disorders (96%). Most adhered to treatment (91.9%) and showed good clinical improvement (61.3%). The clinical outcome groups did not differ significantly in mean age, which was inhomogeneous (P=0.072). Clinical outcome was significantly associated with CTEV classification (P=0.003) and parental adherence to managing CTEV patients with the Ponseti method (P=0.032) but not with patient age at presentation (P=0.587) and comorbid congenital abnormalities (P=0.362).CONCLUSIONS: The clinical outcomes of CTEV patients treated with the Ponseti method were associated with CTEV classification and parental compliance. Physicians should encourage the guardians and/or parents to follow the protocol to increase the successful correction.

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