Comparison between unilateral and bilateral clubfoot treated with Ponseti method at walking age: static and dynamic assessment.

Abstract

This study evaluated the static, postural, dynamic, and clinical outcomes among five groups of patients: a bilateral CTEV (congenital talipes equinovarus) group treated with tenotomy ( n = 14), bilateral CTEV group treated conservatively ( n = 6), unilateral CTEV group treated with tenotomy ( n = 7), unilateral CTEV group treated conservatively ( n = 3), and control group ( n = 20). Data were collected through baropodometric examinations and clinical evaluations using Pirani, clubfoot assessment protocol, foot and ankle disability index (FADI), and American Orthopedic Foot and Ankle Society scores. Bilateral CTEV patients treated with tenotomy showed no statistically significant differences compared to healthy controls. Significant differences were found in lateral-lateral variation in the bilateral postural group ( P  = 0.002) and in static peak pressure in unilateral tenotomy patients ( P  = 0.046). Dynamic comparisons revealed significant differences in mean pressure between unilateral groups ( P  = 0.002) and lateral-lateral variation in bilateral groups ( P  = 0.004). The Pirani score showed significant differences between tenotomy-treated and postural patients ( P  = 0.000). Statistically significant differences in FADI scores were found between bilateral groups ( P  = 0.0037), between tenotomy-treated groups ( P  = 0.0020), and between the bilateral tenotomy-treated group and the unilateral postural group ( P  = 0.021). Bilateral CTEV patients treated with tenotomy develop static and dynamic values comparable to healthy controls. Bilateral patients develop better dynamic values compared to patients with a unilateral variant. Level of evidence: III.