Ponseti’s vs. Kite’s method in the treatment of clubfoot-a prospective randomised study

摘要

Ponseti’s and Kite’s methods of conservative management in idiopathic congenital clubfoot were compared in a prospective randomised study consisting of 45 infants (67 feet) younger than 3 months, from March 2003 through February 2004. There were 36 and 31 feet that underwent treatment by Ponseti’s and Kite’s methods, respectively. After an average follow-up of 27.24 months in the Ponseti group, correction was achieved in 33 feet (91.7%), with only three patients requiring surgical management. There were seven relapses (21.1%), all of which were corrected conservatively. However, two of these required surgical intervention on showing a relapse again in the second year. In the Kite group, we achieved correction in 21 feet (67.7%) after an average follow-up of 24.8 months, with ten patients requiring surgical intervention. There were eight relapses of which only four could be corrected conservatively. We could also achieve correction in very severe feet (Dimeglio classification) in a significantly higher percentage using Ponseti’s method, in significantly lesser time and with fewer casts. We are of the opinion that Ponseti’s method is superior to Kite’s method in achieving correction in idiopathic clubfeet in a relatively shorter period of time when used to treat young infants.