2 hrs old pt with CTEV foot left….can we start serial pop casting rt now…..what is the current recommendation of ponseti method ……??????
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Dhirendra Vikram Singh If skin is not so thin as in premature baby ..start serial manupulations..if so then better to avoid cast n demonstrate her mother maupulation..
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Ali Abdelreheim Ali Omara Examine the hip for DDH and examine the leg then foot then start manipulation then ponsetti method if skin will not tolerate but better start casting
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Rudra Narayan Pandey DrUmesh Kumar
Boss
Casting should be started as soon as the baby is brought to you but we are tought to start after a week for two reasons…
1. POP disturbs the mother and baby contact. The new born should be in close contact with mother…psychological and hormonal effects.
2. The new borns has very delicate skin…POP can damage it.
You know up to two years ponseti works well… there is no harm in delaying for a week or so.
You still have ample of time. Give mother time to recover from post partum effect and baby to know her/ his mother -
Paul Antony You can start serial casting any time we used start after 1 to 2 weeks. More important thing is that if the baby is too small. After 5 serial casting you will not get the proper Size DB shoes. This is very important. We are facing this situation some times
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Vivek Shrivastava Start as soon as possible preferably today,as time pass child become more cranky and gets difficulties in cooperation.
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Suman NV start after 1 week. first concern is baby’s skin will be delicate and fragile. you can ask mother to manipulate the foot while breast feeding for 1 week
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Paul Antony Does manipulation by mother initially has any role. So many of the colleagues write manipulation by mother. actually no need
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Verghese Joe Ponseti can begin on day 1, but usually a gap of a week is given.. So that the mother is given an opportunity to bond with the child and also so that she learns to maintain hygiene.
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Gaurav Singh a week gap is not a problem..but explain mother about doing serial stretching of the foot..
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Nadir Shah Thr s no litreture supporting d exact time to start ponseti, it shd b started as soon as possible considering d baby’s skin it differs to institute to institute n people to people,but yes mother shd b taught manipulation till casting s started..
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DrMithilesh Gupta if skin condition allows, ponsetti casting should be started as soon as possible after birth
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Mohamed Adel it maybe positional due to position of baby in uterus,is it flexible or not if flexible and return to normal position easily no need for cast and serial stretching is done
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Avishek Ray Ghatak Accelerated Ponseti…5day intervals…check global-health.org for procedure…probably require 5-6 casts…TA tenotomy a must to prevent recurrence of equinus…most importantly, educate the patient party of the requirement of a correct Foot Abduction Orthosis…after serial casting…Left foot 70 degree abduction…Right 45 degree…and the hours of wear…22/24hours…den Night n Nap protocol…I feel the biggest problem with recurrences is lack of patient education…parents come back saying that the shoes have become too small or the child refuses to wear them….
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DrHariprasad Chowdary Munnangi I accept with Dr. Rudra.
Ponseti is wonderful technique.
casting can b started 2 weeks later. Teach mother about serial stretchings till then.
Ponseti cast can b changed at weekly basis.
Parent education is very important. They shud follow ur orders till 3 yrs. orelse recurrence may occur.
I prefer percut tenotomy in most of my cases.
All the best. -
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Shrikrishna Dhone initially corrective strapping by sticking plaster,followed by corrective sequential plasters
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Pavankumar Ravi please rule out secondary causes before labeling it as idiopathic club foot, if idiopathic clubfoot then its your choice how early you want to cast based on your comfort levels with casting without anaesthesia, earlier better…
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Pavankumar Ravi As Dr. Ashish has rightly pointed always do tenotomy after achieving an abduction of about 70 degrees
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Santosh Mahapatra Ponseti has not given any guideline about when to start but should be started as soon as possible… and 2 hr is too young and skin might be too soft to start. Can be waited up to 2 wk and then start.
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P Rajasekhar Rao after two weeks u need to start serial casting as of now u can do softissue stretches
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Avishek Ray Ghatak Is there any evidence to suggest that Ponseti’s casting interferes with mother child bonding…or skin problems related to the casting technique…Ben Sahel’s strapping seems to be a temporising method here…which I cannot fathom why…mother manipula…Ver más
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Pedro Jorba I have never had skin problems when using Ponseti casts in newborns; proper padding will prevent it
