The importance of foot abduction brace after the Ponseti treatment of clubfoot

Abstract

Abstract The aim of this study was to find out the role and importance of foot abduction brace after the completion of clubfoot treatment by Ponseti method. In the interval 2014-2016, a series of 51 children (74 feet) suffering of clubfoot were treated according to the Ponseti method in our department. Of them, 36 children satisfied the inclusion criteria in the study. Compliance with orthoses was defined in the terms below: 23 hours/day in the first three months after the cast removal and minimum 8 hours/day up to the age of 3 years. Non-compliance was defined as the incapacity of observing the criterion mentioned above up to the age of 18 months. Out of the 36 patients, 25 (69%) patients (35 feet) complied with the requirement and 11 (31%) patients (15 feet) did not comply with the foot abduction orthoses. At the age of 18 months, it was found out that in the non-complying group, the Pirani score increased significantly as compared to the complying group which means a deterioration of the initial result. Another finding with reference to the foot abduction orthoses complying group is that the Pirani score was maintained or improved significantly (p<0.05), while with the non-complying group the initial results obtained by plaster casts were damaged due to lack of use of orthoses (p<0.05). We consider the correct use of the foot abduction orthoses as essential for the conservative treatment of the clubfoot according to the Ponseti method, in spite of the obstacles sometimes put by parents.