Only Casting Ponseti Treatment for Pes Equinovarus: Satisfactory Long-term Clinical Results without Achillotomy

Abstract

The purpose of this study is to evaluate long-term clinical results of pes equinovarus patients treated with the Ponseti casting method without achillotomy. 13 feet of 10 patients who were treated between August 2004 and April 2007 were re-examined in 2020 April. The mean Pirani and Dimeglio scores were 4.5 (Range:4-6) and 14.5 (Range:12- 18) at the beginning of the treatment. At the last follow-up, the mean of the American Orthopaedic Foot & Ankle Society (AOFAS) score was 88.9 (Range: 81-96. The mean plantar flexion was 25 degrees (Range: 2030). The mean forefoot adductus was measured to be 7 degrees (Range: 0-10). The mean heel varus while standing was 4.5 degrees (Range: 0-10). There was no loss of muscle power in ankle dorsiflexion and plantar flexion. All of the patients were free of pain and were integrated into life. If neutral dorsiflexion is acquired without achillotomy, mild foot deformity and a moderate ankle range of motion restriction are well tolerated after Ponseti treatment in the long term.