Ponseti method in patients with myelomeningocele a fifty-patient-series matched with idiopathic cases

Clubfoot is present in approximately 30–50% in patients with meningomyelocele, and its treatment aims to minimize the impact on mobility and quality of life of these children. Treatment options still include multiple surgical procedures. However, the indications for the Ponseti method expanded in the early 2000s with its use for myelodysplastic feet. The hypothesis of this study is that the Ponseti method in patients with meningomyelocele and Clubfoot has similar results to patients with idiopathic clubfoot. This is a retrospective observational cohort study from 2004 to 2024 comparing a group of patients with Clubfoot and meningomyelocele who underwent treatment using the Ponseti method with patients with idiopathic Clubfoot who underwent correction using this method. The first with 50 patients (83 feet) with Clubfoot and meningomyelocele and the second with 170 patients with idiopathic Clubfoot (293 feet). Initial correction was achieved in 96% of myelomeningocele patients, and 82% maintained correction at final follow-up. No significant differences were found between groups regarding initial Pirani score, final Pirani score, number of casts, or recurrence rate. Complications were significantly more frequent in myelomeningocele patients (44% vs. 8%). Subgroup analysis showed no significant differences between high and low lumbar levels in number of casts, complications, or need for tenotomy. Regarding subgroup analysis, high and low lumbar meningomyelocele, the initial Pirani score, and bilaterality presented statistically significant differences.