Evaluation of ponseti method by the pirani score in the treatment of clubfoot

Objective: To evaluate the treatment of idiopathic congenital equine varus varus club feet in children under 2 years of age using the Pirani score. Patients and method: This is a prospective study spread over a period of 24 months in the pediatric surgery department of the CHRHL of Diourbel. The study concerned cases of idiopathic equine varus clubfoot for which treatment with the Ponseti method was initiated. We included in this study all patients aged 0 to 24 months who had idiopathic clubfoot, with a minimum follow-up of 12 months. We collected 29 patients with a sex ratio of 1.9. The mean age of diagnosis was 4 months with extremes of 7 days and 13 months. The age group from 1 month to 5 months was the most represented. Bilateral forms accounted for 75.86% of cases. Patients with idiopathic clubfoot were in the majority with 86.20%. The Pirani score (SP) rated initial deformities and treatment outcomes. Results: The Pirani score at the start of treatment was severe in 58.62% of cases. The number of casts per clubfoot averages 4 with extremes from 1 to 8. Clubfeet that received 1 to 4 casts accounted for 52.84% of cases. Tenotomy was performed in 81.25% of typical idiopathic and syndromic clubfoot cases. It was not necessary in positional clubfeet. 84% of the treated feet had a very good result at the time of splint wearing with a Pirani score of zero. The Pirani score after a 6-month follow-up made it possible to note 72.5% of very good results and 8% of recurrence. Conclusion: The Pirani score is effective in evaluating the treatment of clubfeet. Early treatment with the Ponseti method gives very good results. Recurrences mainly concern syndromic clubfeet.