Treatment of recurrent pes equinovarus by ponseti method

Aim: The initial treatment in relapse PEV is controversial and conservative or surgical methods can be applied. Although the general trend is tend to perform surgical treatment when Ponseti method fails, surgical treatments are difficult, complication rates are high, and long-term results are not good enough. In this study, the effectiveness of Ponseti method which as in primary PEV, has a low complication rate and is inexpensive, easy to apply, was investigated at relapse PEV treatment. Materials and Methods: In the study, 26 patients with idiopathic PEV and 4 patients with non-idiopathic PEV, 49 feet of a total of 30 patients were retrospectively analyzed. 17 (56.7%) of the patients were boys and 13 (43.3%) were girls. Ponseti method was used as treatment method. Additional surgical interventions, which are the continuation of the method, were performed when necessary. Total Pirani scores, Pirani subscores (HFCS, MFCS), Dimeglio scores and grades were recorded in the patients' relapse detection and post-treatment controls. In addition, information such as additional diseases, whether there are any other patients with PEV in the family, number of plasters, number of relapses, orthosis type and orthosis compliance, parental education status, and the presence of deformity requiring intervention at the last control were collected. Results: In our study, there was a significant relationship between PEV type and number of relapses. There was no relationship between relapse and age at first treatment. It was seen that education level of mother and father did not affect orthosis compliance. The average of Pirani score before the treatment was 3,02 and the average of Dimeglio score was 8,5. After treatment, the average of Pirani score was 0,99 , the average of Dimeglio score was 5,06 , and improvement was statistically significant. Improvement in non-idiopathic PEV was low and the need for additional surgery was higher. Conclusions: It was concluded that the relaps PEV treatment with Ponseti method, which is inexpensive, simple and has a low complication rate, is effective as in the treatment of primary PEV. To increase success in relapse PEV, the method should be applied without modification. Deformity components must be well analyzed and recurred components treated in order. Achilles tenotomy and / or TATT should be added to the treatment in cases required after plastering. Keywords: Pes equinovarus, relapse PEV, Ponseti method