Outcome of Syndromic Congenital Talipes Equinovarus in Children Treated by Ponseti Technique at a Tertiary Care Centre of Northeast India

Background: Among congenital abnormalities affecting lower limb, syndromic congenital talipes equinovarus has prevalence rate ranging from 1.1 to 1.6 per 1000 livebirths¹. Most cases of clubfeet are thought to be idiopathic, meaning they happen randomly at birth. On the other hand, neuromuscular and syndromic diseases constitute most of syndromic congenital talipes equinovarus cases. The aim and objective is to study the incidence and sociodemographic profile of syndromic congenital talipes equinovarus, identifying the clinical profile of syndromic CTEV and to study the efficacy of Ponseti method in management of syndromic CTEV. Material and Methods: A hospital based prospective study was done at orthopedics department of a premier tertiary care hospital of North-East India. All clinically diagnosed syndromic CTEV cases were included in the study. Results: Most patients were aged 1–5 months at presentation, with a male predominance (male: female ratio 1.35:1). Bilateral involvement was observed in the majority of cases. Arthrogryposis multiplex congenita was the most common associated syndrome. All patients underwent Achilles tendon tenotomy and were treated with a foot abduction brace. Good compliance with treatment was observed in 92.5% of patients, while relapse occurred in only 7.5% of cases. The most common final Pirani score was 0.5/0.5 (47.5%), indicating satisfactory correction. The mean age at first cast application was 6.31 ± 10.26 days, the mean number of casts required was 9.8 ± 1.51, and the mean follow-up duration was 11.28 ± 1.30 months. Conclusion: We concluded that Ponseti technique demonstrates favorable outcomes in treating syndromic CTEV, offering high correction rates and improved functional mobility. Ongoing monitoring and individualized treatment adjustments are crucial to managing relapse and optimizing long-term results. Further research is needed to refine protocols tailored to specific syndromic variants and to explore the broader impacts on quality of life and social functioning in affected children.

Keywords: Congenital talipes equinovarus, clubfoot, syndromic, Ponseti technique, systematic review.