Atypical clubfoot :Early Identification and treatment by modification of standard Ponseti technique.

Title: Atypical Clubfoot: Early Identification and treatment by modification of standard Ponseti technique. Introduction: Atypical clubfoot is a clinical variant of idiopathic clubfoot which requires early detection by the orthopaedician and modification in the standard protocol of treatment as described by Ponseti. The goal of treatment is to reduce or eliminate its four components so that the patient has a functional foot and leads a normal life. Material and methods: We identified 16 patients with 16 idiopathic atypical clubfoot deformity .Clinically, atypical clubfeet is defined as having rigid equinus, severe plantar flexion of all metatarsals, a deep crease above the heel, a transverse crease in the sole of the foot, short foot and a short and hyperextended first toe. Results: Correction was achieved in all patients by modifying the standard Ponseti manipulation and casting technique. The mean number of casts that were applied to obtain correction was 7 (range four to nine casts). Tenotomy was done in all feet. At the time of last follow up all the feet were considered clinically cured. Conclusion: Modified Ponseti method is a safe and effective treatment for congenital idiopathic atypical clubfoot and radically decreases the need for corrective surgery.