Ultrasound Appears Effective Method of Monitoring Progress During Ponseti Treatment for Clubfoot

Young children with clubfoot are usually treated using the Ponsetti treatment. Researchers felt that ultrasound over the course of the treatment would allow for accurate assessment of treatment progress because of the good visualization with ultrasound of the young bones.

Researchers enrolled 26 patients, six of whom had bilateral clubfoot (both feet), for a total of 32 clubfeet. Patients were between 12 days and three months old; all patients had nonidiopathic clubfeet, not as the result of other disorders or deformity. The controls for the study were the non-affected feet in patients with only one clubfoot.

The clubfeet were scored by the researchers using the International Clubfoot Study Group (ICFSG) criteria. Before and after each manipulation, done weekly, clinical evaluation was performed using the Pirani scoring method. Ultrasound evaluations were done throughout treatment by a pediatric sonologist with experience taking these particular measurements. The manipulations were performed by a pediatric orthopedic surgeon.

The results of the study showed an average pre-treatment score of 14/20 using the ISCFSG scoring system. Using the Pirani scoring system, six feet had scores between three and four, and 26 feet had scores between four and six.

Surgery was required to release the Achilles tendon in 32 feet. At the end of the treatment, all patients had a score of zero according to the Pirani score.

The authors conclude that using ultrasound, which is relatively inexpensive and easy to access, to monitor the progress of clubfoot correction is effective and can help detect problems early on in treatment.