الفهرس 
Analysis of the possible causes of relapsed deformity following ponseti technique in the management of idiopathic clubfeet
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Abstract
The aim of this article is to review the possible causes of relapsed deformities following Ponseti technique in the management of idiopathic clubfeet. Methods: A total of 65 children with 105 idiopathic clubfeet , with successful initial treatment by the Ponseti method, were evaluated in Abo El Reesh paediatric hospital during the period between March 2015 and December 2016. The patient characteristics at the time of presentation, such as the severity of the initial clubfoot deformity, previous treatment, and the age at the initiation of treatment were examined. Demographic data on the family, including residency, monthly income, highest level of education attained by the parents, and marital status, as well as parental reports of compliance with the use of the prescribed orthosis, were studied as possible causes of relapsed deformities. Results: Sixty-five children (105 feet) were reviewed for relapse of their deformities forming 28% of the total idiopathic clubfeet. There were 44 males (67.7% ) and 21 females (32.3%). Only four patients had a positive family history of clubfoot. 40 cases (61.5%) were bilateral clubfeet , 25 patients (38.5% )had unilateral relapsed feet. 51 cases (83 feet) were Non-Compliant with Dennis_Brown splint protocol forming 78.5% of the patients . Age of the patients at time of relapse ranges from 10 to 23 months (average 16.15 months), Age at the start of the castings ranges from 5 days to 75 days (average 25.58 days). Number of serial castings ranges from 4 to 15 castings , with an average of 9.31 casts. 58 patients (89.2%) did percutaneous tendoachilis tenotomy at initial correction . Total Pirani score at the begining of casting : ranges from 3 to 6 , with an average of 4.96 . The mean Duration of follow up was 12.49 months ( range 7 months to 19 months ). The mean Socioeconomic score according to the Modified Kuppuswamy’s socioeconomic status scale was 8.45 , ranging from 4 to 17