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Conservative management of idiopathic clubfoot: Kite versus Ponseti method
Sanghvi AV, Mittal VK
Journal of Orthopaedic Surgery 2009 Apr;17(1):67-71
clinical trial
4/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

PURPOSE: To compare the long-term results of the Kite and Ponseti methods of manipulation and casting for clubfoot. METHODS: 42 patients (with 64 idiopathic clubfeet) were equally randomised to Kite or Ponseti treatments in the early weeks of life. 14 males and 7 females (34 clubfeet) were treated by the Kite method, whereas 13 males and 8 females (30 clubfeet) were treated by the Ponseti method. All the clubfeet were manipulated, casted, and followed up (for a mean of 3 years) by one experienced orthopaedic surgeon. The final results were compared. RESULTS: The success rates for the Kite and Ponseti treatments were similar (79% versus 87%). With the Ponseti method, the number of casts was significantly fewer (7 versus 10); the duration of casting required to achieve full correction was significantly shorter (10 versus 13 weeks); the maximum ankle dorsiflexion achieved was significantly greater (12 versus 6 degrees); and the incidence of residual deformity and recurrence was slightly lower. CONCLUSION: The Ponseti method can achieve more rapid correction and ankle dorsiflexion with fewer casts, without weakening the Achilles tendon.

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