Congenital Talipes Equinovarus : A Systematic Review of Relapse as a Primary Outcome of the Ponseti Method

Febri Pranata Utama

doi:10.55606/ijhs.v6i2.7238

Authors

Febri Pranata Utama Bhayangkara Level III Hospital

DOI:

https://doi.org/10.55606/ijhs.v6i2.7238

Keywords:

Clubfoot Recurrence, Congenital Talipes Equinovarus (CTEV), Foot Abduction Brace Compliance, Long Term Follow-Up, Ponseti Method

Abstract

Congenital Talipes Equinovarus (CTEV) or clubfoot is a common congenital musculoskeletal deformity characterized by cavus, adduction, varus, and equinus abnormalities. The Ponseti method is currently the gold standard for conservative treatment of idiopathic CTEV due to its effectiveness and minimally invasive approach. This systematic review aimed to evaluate recurrence rates following Ponseti treatment and identify factors associated with relapse. The review was conducted according to PRISMA guidelines using PubMed, Scopus, Embase, and Cochrane Library databases. Studies involving idiopathic CTEV patients treated with the Ponseti method and followed for at least two years were included. Of 310 identified articles, five studies met the eligibility criteria. Recurrence rates ranged from 3.7% to 67.3%, with an average of approximately 20–30%. The main factors associated with relapse were poor compliance with foot abduction brace use, higher Pirani scores, age at initial casting, and longer follow-up duration. Recurrence commonly presented as equinus, adduction, varus deformities, or dynamic supination. Although most relapses responded to repeat casting or minimally invasive procedures, severe cases required additional corrective interventions. Long-term follow-up, family education, and brace adherence remain essential for preventing recurrence and maintaining successful outcomes.

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