The Original Denis Brawn Brace versus Its Modification for Management of Relapsed Idiopathic Clubfoot Following Ponseti Casting: A Retrospective Study

Background: Relapse of idiopathic congenital talipes equinovarus (CTEV) after initial Ponseti correction remains a clinical challenge, with bracing compliance and design playing critical roles in maintaining correction. Purpose: This study aimed to compare the effectiveness of the original Denis Browne splint with a modified version in managing relapsed idiopathic CTEV. Patients and Methods: This retrospective study was conducted on 60 patients aged 2 to 4 years old with relapsed idiopathic CTEV who had previously been treated with the Ponseti method. Patients were divided into two equal groups based on the type of brace: Group I used the conventional Denis Browne splint, and group II used a modified brace featuring custom-moulded inserts. Radiological parameters and Pirani scores were recorded at baseline and during follow-up. Parental compliance and complication rates were also evaluated over 12 months. Results: Final Pirani scores and radiological parameters, including the talocalcaneal angle and index were significantly better in group II than in group I (P< 0.05). A significant improvement in Pirani scores was seen at the two-month follow-up in group II (P= 0.031). Compliance and complication rates were statistically similar between groups. Conclusion: The modified Denis Browne splint offers superior radiological and clinical outcomes in maintaining correction following Ponseti casting for relapsed idiopathic CTEV, without increasing the risk of complications or reducing compliance.