COMPARATIVE STUDY OF PONSETI METHOD VERSUS FRENCH FUNCTIONAL METHOD IN THE TREATMENT OF IDIOPATHIC CLUBFOOT

Abstract

Background

Idiopathic clubfoot is a common congenital deformity affecting the musculoskeletal system. The Ponseti method and the French functional method are two widely used non-surgical approaches for its management. This study aims to compare the effectiveness of these two techniques in terms of treatment success, recurrence rate, and functional outcomes.

Materials and Methods

A prospective comparative study was conducted on 60 infants (90 feet) diagnosed with idiopathic clubfoot. The participants were randomly allocated into two groups: the Ponseti method group (n=30, 45 feet) and the French functional method group (n=30, 45 feet). The Ponseti technique involved serial manipulations, casting, Achilles tenotomy (if required), and bracing. The French method included daily physical therapy, stretching, taping, and splinting for the first three months, followed by a gradual transition to night splinting. Treatment outcomes were assessed at six months and one year using the Pirani score, Dimeglio classification, and the rate of recurrence requiring additional intervention.

Results

At the one-year follow-up, the Ponseti method demonstrated a significantly lower mean Pirani score (0.5 ± 0.2) compared to the French method (1.2 ± 0.3) (p<0.05). Successful correction was achieved in 90% of cases using the Ponseti method versus 75% in the French method. The recurrence rate was higher in the French method group (20%) than in the Ponseti group (8%). The need for additional surgical intervention was also more frequent in the French group (15%) compared to the Ponseti group (5%).

Conclusion

Both methods are effective for managing idiopathic clubfoot, but the Ponseti method showed superior outcomes in terms of correction, recurrence rate, and need for surgical intervention. Given its simplicity, cost-effectiveness, and higher success rate, the Ponseti technique should be preferred for primary treatment.