Clinical Outcomes of Accelerated versus Standard Ponseti Method in the Management of Idiopathic Congenital Clubfoot

Open Access

Abstract

Background: Congenital idiopathic clubfoot is a common pediatric deformity effectively managed by the Ponseti method. The accelerated protocol may reduce treatment duration and improve compliance, but comparative evidence from Bangladesh remains limited. This study aims to compare correction outcomes, treatment duration, and relapse rates between accelerated and standard Ponseti methods to determine the optimal approach for local patients. Methods & Materials: A prospective comparative study was conducted at NITOR, Dhaka, Bangladesh, involving 20 infants with idiopathic congenital clubfoot. Patients were allocated into accelerated (n=10) and standard (n=10) Ponseti groups. Cast changes were performed twice weekly and weekly, respectively, following the Ponseti protocol. Clinical outcomes were assessed using the Pirani score, and data were analyzed using SPSS with p<0.05 considered statistically significant. Ethical approval was obtained, and written informed consent was secured from all parents or guardians. Results: Among 20 infants, 10 were treated with the accelerated Ponseti method and 10 with the standard Ponseti method. Baseline demographic and clinical characteristics were comparable between the groups. Complete correction (Pirani score 0) was achieved in 80% of the accelerated group and 90% of the standard group (p=0.53). Both groups demonstrated marked improvement in Pirani scores after treatment, with no statistically significant differences in final scores or mean score reduction (p>0.05), indicating similar effectiveness of both treatment protocols. Conclusion: Both accelerated and standard Ponseti methods are effective for correcting idiopathic congenital clubfoot, achieving comparable clinical outcomes and high correction rates. The accelerated protocol may reduce treatment duration while maintaining effectiveness, making it a potential alternative, particularly in resource-limited settings.