Modified Ponseti technique in the treatment of resistant, relapsed, neglected and atypical clubfoot- A case series of 20 patients

Congenital talipes equino varus is one of the most common pediatric foot deformities occurring in 1 in 1000 live births. Several conservative and non-conservative methods are described for the correction of the clubfoot deformity. The Ponseti method is currently the most accepted method for the treatment of the clubfoot deformity. We did certain modifications in the Ponseti technique to treat resistant, relapsed, neglected and atypical clubfoot. The modifications include percutaneous plantar fascia release before applying the first above knee cast and the second modification include an open tendo-achilles tenotomy before applying the final cast. Our case series included 20 patients and 31 feets that were treated by the modified ponseti protocol. Mean number of cast required is 4.4. Our modification of ponseti technique in resistant, relapsed, neglected and atypical clubfoot results in shorter treatment duration and a lesser number of casts.