COLLABORATIVE MANAGEMENT OF CONGENITAL CLUBFOOT: INTEGRATING PAEDIATRIC AND ORTHOPAEDIC CARE VIA THE PONSETI TECHNIQUE

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Abstract

Background: Congenital Talipes Equinovarus (CTEV), commonly known as clubfoot, affects roughly 1–2 per 1,000 live births and often goes untreated in low-resource settings due to limited awareness and capacity. Objective: To evaluate how joint paediatric–orthopaedic collaboration impacts clinical presentation and the effectiveness of the Ponseti method in infants with idiopathic CTEV. Methods:In this observational study, 40 infants (60 feet) presenting to the paediatric outpatient department with idiopathic CTEV were referred for Ponseti serial casting, tenotomy when needed, and bracing. Demographic and clinical data were recorded using a structured proforma. Correction was monitored by the Pirani score at each visit. Results: Mean age at treatment initiation was 3.5 weeks. Of 40 infants, 29 (72%) were male and 11 (28%) were female; 20 (50%) had unilateral involvement and 20 (50%) had bilateral clubfoot.7, 8, and 9 casting sessions were required in 09 (22.5%), 20 (50%), and 11 (27.5%) infants, respectively. After correction, 54 feet (90%) achieved a Pirani score < 0.5.Out of 60 clubfoot 15 feet (25%) required tenotomy and 5 feet(8.33%) required posteromedial soft tissue release. Conclusion: Early identification of clubfoot by paediatricians and prompt intervention by orthopaedic surgeons using the Ponseti method leads to high rates of correction and minimizes the need for extensive surgery. Astructured referral pathway between paediatrics and orthopaedics should be promoted as the standard of care for CTEV.