Factors Related to Relapse of Congenital Talipes Equinovarus (CTEV) After the Ponseti Method

Abstract

BACKGROUND: Congenital talipes equinovarus (CTEV) is one of the common congenital disorders in pediatric orthopedic practice that affects a large group of children.It is a combination of four parts of deformity that affect either a single foot or both feet. Our aim in this study is to estimate the prevalence and incidence of CTEV and to evaluate the risk factors that lead to relapse in some children to avoid relapse in future and complex surgical interventions, as well as to improve the final outcome. MATERIALS AND METHODS: A retrospective cohort study for the cases of CTEV was conducted to estimate the prevalence of relapse in children with CTEV after management by the Ponseti method and to evaluate the risk factors that lead to recurrence. RESULT: The study includes 103 patients with CTEV, and only 22 patients had relapse. The prevalence rate of relapsed cases was 20.4%, and the incidence was 42 per thousand. The average number of casts applied was 4.05 ± 1.37. The average severity of the deformity that was measured by the Pirani score was 4.97 ± 1.21. The most common atypical presentation of CTEV was associated with developmental dysplasia of the hip (DDH), followed by myelomeningocele (MMC). CONCLUSION: The only significant factors in the study were the Pirani score and non-compliance of the brace with p < 0.05. There was not any significance in the correction of the deformity by Ponseti between idiopathic and non-idiopathic CTEV based on the number of casts and the Pirani score. The dynamic foot brace can be the solution for the high recurrence rate, yet more studies are needed in the future.