الفهرس 
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Abstract
Congenital Clubfoot, otherwise known as Congenital TalipesEquinoVarus (CTEV) is one of the commonest deformities occurring at the region of the ankle, subtalar and mid-tarsal joints, the deformity comprises of three elements: Inversion (twisting inward) of the foot, adduction (inward deviation) of the forefoot relative to the hindfoot and equinus (plantar flexion).
Historically, talipesequinovarus was recognized and documented since the time of the ancient Egyptians.
It occurs in every 1.2 of 1000 live births and is the most common musculoskeletal congenital birth defect. Males are more commonly affected than females and up to 50% of cases are bilateral. The etiology of congenital clubfoot is largely idiopathic, however it can be associated with other conditions such as spina bifida, arthrogryposis or other syndromes in approximately 20% of the cases.
Over the past few decades, there has been extensive research regarding the appropriate treatment for clubfoot. Historically, surgical correction, specifically an extensive posteromedial soft tissue release, was the mainstay treatment option. This intervention, however, has been shown to result in severe scarring, joint stiffness, muscle weakness, gait disturbances and relapses. Additionally, complications including wound infections, skin necrosis and neurovascular injuries have been reported. Furthermore, the deformity can be over- or under-corrected and the talus may be flattened or even result in necrosis.
Treatment preferences have since changed to primarily a non-operative approach through the Ponseti method which involves manipulation, a series of castings, percutaneous Achilles tenotomy and foot bracing.
Material and Methods
Twenty patients (29feet) with clubfoot deformity were managed prospectively at in Beni Suef University Hospital and BeniSuefHealth InsuranceHospital using Ponsetimethod (manipulation, serial casting, percutaneous Achilles tenotomy and foot abduction brace), the age of infants at presentation ranges from 1 to 10 months (average 5 months), Pirani severity score was used to assess the feet .duration of follow up ranges from 14 to 25 months (average 18 months).
Results
The overall results were satisfactory in 19patients (27 feet)after an average follow-up of 18 months. The Pirani score improved from a median of 5.5at presentation to a final follow-up median of0.5. One infant (2 feet) had unsatisfactory result with apretreatment score of six and a final score of five.
Conclusion
Our study suggests that the use of Ponseti method in management of club foot in infants under the age of 1 yeargives a good results.