Common mistakes, difficulties and complications during ponseti management of congenital idiopathic club foot

Background: Idiopathic clubfoot is a congenital deformity with incidence of 1-2 per 1000 live births. Various techniques both surgical and non surgical are mentioned in literature for treatment of CTEV. Ponseti method is a relatively new technique with success rate of upto 94% reported in numerous studies. Current trend in treatment of this condition has shifted from extensive surgical release to conservative techniques like Ponseti method. Objectives: We evaluated the difficulties and complications encountered during the Ponseti method for the treatment of Congenital Idiopathic Clubfoot. We also searched answers to many commonly asked questions about clubfoot. We also watched our mistakes and tried to correct them over a period of time. Methods and Results: The study was conducted on 79 patients with 123 idiopathic clubfeet. All our patients were less than six months of age. We followed these patients for a period of 2 years and noted the difficulties and complications encountered during the Ponseti treatment and post-tenotomy bracing of these clubfeet. We noticed various difficulties and complications during ponseti treatment. Difficulties we encountered were from difficulty in palpating talar head during manipulation, difficulty in getting 60-70 degree abduction and many more. Complications we encountered were sliping of plaster cast to cutting of peroneal artry during tenotmy. Conclusion: The Ponseti method has become the gold standard for the initial treatment of the clubfoot. There are not many studies which show the difficulties and complications associated with this method of treatment. With ever increasing number of clubffoot patients being treated by the ponseti method, there is a need to ponder into the complications associated with this method of treatment.