Factors Associated with the Number of Casts in the Management of CTEV by Using the Ponseti Method :A Retrospective, Analytical Study

Abstract

The Ponseti method is an effective technique for treating Congenital Talipes Equinovarus (CTEV), which involves serial casting to correct the deformity. We investigated the correlation of the number of casts with patient’s age at presentation, initial Pirani score and Dimeglio score. This was an analytic retrospective study of CTEV patients treated with the Ponseti method in Dr. Wahidin Sudirohusodo Hospital from January 2011 to December 2018. Variables of initial Pirani score, Dimeglio score, age at presentation, and the number of casts to achieve correction were collected from the patient’s medical record. The data obtained were subjected to statistical analysis using ANOVA test and Spearman correlation test.  There were 90 patients included in this study. Male (64 % ) are more common than female. Patients with bilateral foot disorders are more often than unilateral. The most common age at the first presentation is under the age of 1 month. Most patients require four circular casts. The initial average of Pirani score is 0.7 and the initial average of Dimiglio score is 13.0. Analysis of each variable with ANOVA test showed that age had a significant relationship (p <0.001), Pirani score (r = +0.885), and Dimeglio score (r = +0.76) had a significant positive correlation with the number of circular cast.The number of circular casts needed to correct CTEV correlates significantly with the age of first presentation and has a strong positive correlation with both the initial Pirani score and the initial Dimeglio score.