Title : Correlation between early radiological findings and medium-term clinical outcome of a cohort of ponseti treated CTEV patients at a UK District General Hospital
Abstract:
Introduction: Congenital Talipes Equinovarus (CTEV) is a common congenital condition, which can result in long term deformity, functional debility and pain if untreated. Primary treatment is serial casting (Ponseti method). We present a large series of children with CTEV, documenting radiological outcomes after using the Ponseti method with at least 10 year follow up.
Aim: We aimed to describe clinical and radiological outcomes of all CTEV patients treated at a UK District General Hospital (DGH) with at least a 10 year follow up period.
Methods: Patients were identified using a local database. Patients born between July 2001 and December 2014 with a diagnosis of CTEV were included. Patients had radiographs at age five years. Antero-posterior and lateral Kite angles and calcaneal pitch were measured. Reoperation rates and recasting rates were recorded. Clinical outcomes were noted at five years.
Results: 180 patients (263 feet) were included, with median age at initial treatment 3 weeks. Male to female ratio was 3:1. Mean number of cast changes was 6.24. 24/180 patients (13%) underwent secondary procedures. 132/180 patients (74%) had radiographs at age five years. All Kite angles were within normal range, however there was a significant difference in Kite angle in unilateral cases when comparing corrected to normal feet. p<0.000001. No difference was seen in bilateral cases.
Conclusion: We concluded that at five years of age, Ponseti method corrects all Kite angles to within normal range. In unilateral cases there is a significant difference in both AP and lateral Kite angles, which may represent the expected clinical picture of an often imperfectly shaped but functional foot. Clinically, the majority of cases had acceptable morphological and functional feet.
