الفهرس 
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Abstract
The Ponseti method has been repeatedly shown to provide excellent correction of infantile clubfoot deformity. The results of Ponseti have been reproduced successfully by a number of surgeons at varied locations of the world. In most places it is the preferred method for treatment of clubfoot deformity.
Congenital idiopathic clubfoot is a deformity typically occurring in an otherwise healthy child. The most recent reports using the Ponseti method showed excellent corrections in the majority of patients.
The operative treatment of the recurrent non-operated clubfoot or the persistently deformed clubfoot after extensive soft tissue release is associated with poor outcomes with significant pain, stiffness and fatigue and repeated surgery has the potential to worsen these symptoms by further postoperative scar formation.
Accordingly, twenty one patients were included in our work. Unfortunately, during follow up period, one patient died due to malnutrition disease and another one lost the follow up, leaving 19 patients to be evaluated in our results .There were 14 boys and 5 girls with 28 involved feet (14 left: 14 Right). with average age 10 weeks all patients were followed up for at least 6 months from the time they started brace wearing (6- 21 months) with a mean period of 13.5 months.
The Ponseti method was applied with good success. 100% of our patients achieved full correction.
Patients included in this study were diagnosed to have idiopathic atypical clubfoot according to clinical criteria proposed by Ponseti and aged two years or younger. Pirani score before starting cast was 6 for all patients reflex the complexity of the deformity, however, at the end of manipulation and before doing the tenotomy, it went down to a mean of 2.2 (2-2.5). The positive final scoring in all patients was confined to persistence of Pirani signs at the hindfoot only.
A fully detailed personal , gestational, family and social history were collected for all of our patients .Complete general examination to exclude any other congenital anomalies favoring the syndromic nature of the deformity. Local examination to elicit the components of deformity, confirm the atypical characters of the involved feet and to document the functional scoring before starting management regime. We carefully looked for and reported any of the atypical characters of the deformity for each foot, including severe equinus and supination, hyperextension and pronation of the big toe, short and stubby foot, with the adducted metatarsals in plantar flexion and deep creases across the sole of the foot and above the heel.