IJOCP | Volume 2015| Issue – April 2015| Page
Conference: Poona Orthopaedic Society Annual Conference POSAC-2015,      India [Click for Full details]  

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Abstract                                                                                                                 

Aims and Objectives: Ponseti method of correction is currently the gold standard for treatment of clubfoot. Parents are usually worried about the motor milestones in these children. The purpose of this study was to evaluate the timing of gross motor milestones achieved in children with severe clubfoot and to find out if there is any difference in unilateral and bilateral clubfoot and also with published Indian normal data (Development assessment scale for Indian infants)

Materials and Methods: 150 consecutive children with idiopathic clubfoot treated by Ponseti method were included in this prospective study. Inclusion criteria were: children less than 3 months with no previous treatment taken elsewhere, no other orthopaedic conditions, full term babies without any neonatal complications. Only children with pre-treatment Pirani score of 4 and more were included in the study. All children had a percutaneous tendochillistenotomy performed after the midfoot score was zero. A foot abduction orthosis was used for 23 hours for 3 months and then night time for 3 yrs. The parents were explained to observe and record 6 gross motor milestones namely1) rolls from back to stomach,2) sitting without support, 3)standing with assistance, 4)walks with assistance,5) standing alone 6) walking alone

Results

10 patients were excluded from the study as they were not compliant with brace wear and were not regular with followup. 5 patients were excluded as there was a recurrence and they had to undergo repeat plasters or surgery. Comparison of normal children and children with unilateral clubfoot( 80 children):  all milestones except rolling from back to stomach were delayed. The delay ranged from 0.3-1.6 months. 95% children had started independent ambulation by 17 months. Comparison of normal children and children with bilateral clubfoot( 55 children). All milestones were delayed with a range of 0.2-2.1 month. 95% children had independent ambulation by 17.8 months. There was also a statistically significant difference in unilateral and bilateral clubfeet in all variables except sitting without support and walks with support.

Conclusion

There is a delay in achievement of motor milestones in children with clubfoot, with more delay in bilateral clubfoot. The probable reasons could be plaster treatment, possible weakness due to tendoachillistenotomy, use of orthosis or the inherent pathology associated with clubfeet. Parents hence need to be explained about this delay.

How to Cite this Abstract
 Gross motor milestones inIndian children with severe idiopathic clubfoot treated by Ponseti methodInternational Journal of Conference Proceedings. March 2015;(2015):55