AI Summary & Key Takeaways
AI InsightPre-treatment Pirani score is the strongest predictor of Achilles tenotomy and should be considered a key parameter in treatment planning.
📌 3 Key Takeaways
Abstract
Aims: Congenital talipes equinovarus (CTEV) is one of the most common congenital foot deformities and is influenced by multifactorial etiological factors, including genetic predisposition, intrauterine environment, and maternal characteristics. Early orthopedic consultation is considered critical for the success of the Ponseti method. This study aimed to evaluate the effects of maternal factors and postnatal orthopedic consultation timing on treatment outcomes in newborns with CTEV based on a 10 year single-center experience. Methods: This retrospective cohort study included newborns diagnosed with CTEV between 2015 and 2025 at a tertiary referral center. Maternal, perinatal, and clinical variables-including maternal age, smoking status, gestational complications, mode of delivery, deformity characteristics, consultation timing, treatment initiation time, and Pirani scores-were recorded. All patients were treated using the Ponseti method. Group comparisons were performed using nonparametric statistical tests, and predictors of Achilles tenotomy were evaluated using binary logistic regression analysis. Results: Among 15.132 live births, 38 infants (0.25%) were diagnosed with CTEV. Most cases were bilateral (63.2%), all cases were classified as idiopathic CTEV, and 73.7% were flexible. Maternal smoking was present in 55.3% of cases but showed no significant association with deformity severity, rigidity, or tenotomy requirement (p>0.05). No significant correlations were observed between consultation duration, treatment initiation time, and Pirani scores (p>0.05 for all comparisons). Ponseti treatment resulted in significant improvement in Pirani scores (median 2 to 0, p<0.001). Achilles tenotomy was performed in 52.6% of patients. Logistic regression analysis identified pre-treatment Pirani score as the only independent predictor of tenotomy (OR=3.61, 95% CI: 1.45-8.98, p=0.006). Conclusion: Maternal characteristics and consultation timing do not appear to influence treatment outcomes in newborns with CTEV. Pre-treatment Pirani score is the strongest predictor of Achilles tenotomy and should be considered a key parameter in treatment planning.