CORRELATION BETWEEN EARLY RADIOLOGICAL FINDINGS AND MEDIUM-TERM CLINICAL OUTCOMES OF PONSETI-TREATED CTEV PATIENTS AT A UK DISTRICT GENERAL HOSPITAL

Introduction Congenital talipes equinovarus (CTEV) is a congenital condition which can result in long term deformity, functional debility and pain if untreated. Primary treatment is Ponseti serial casting. We present our large series of children with CTEV, documenting radiological outcomes with at least 10 year follow up periods. Methods Patients were identified using our local database. Patients born between July 2001 and December 2014 with a diagnosis of CTEV were included. Patients had radiographs at age five. Antero-posterior, lateral Kite angles and calcaneal pitch were measured. Reoperation and recasting rates, along with clinical outcomes were recorded. Results 180 patients (263 feet) were included with median age at initial treatment of 3 weeks. The male to female ratio was 3:1. Mean number of cast changes was 6.24/180 patients. 13% underwent secondary procedures. 132/180 patients (74%) had radiographs at age five years. All Kite angles were within normal ranges, however in unilateral cases the corrected feet had a significantly lower Kite angles than the normal feet (P<0.000001). No difference was seen in bilateral cases. Clinically, most cases had acceptable morphological and functional feet. Conclusion There is a paucity of literature regarding radiological outcomes after treatment of CTEV with the Ponseti method. We show at five years of age, Ponseti method corrects all Kite angles to within normal range, however in unilateral cases there is still a difference in both AP and lateral Kite angles, which may represent the expected clinical picture of an often imperfectly shaped but functional foot.