POA organizes Club Foot Ponseti
Workshop at JPMC

KARACHI: “The Club Foot management has progressively become better and better since days we used to treat. Though it was managed with kite procedure today world has switched to Ponseti method that seems to be better than all others methods. However I am happy that my students are following our teaching of non operative methods to manage Club foot as we used to do and achieved almost 100% correction results. Now we hardly do operative treatment except in those who come late after one year”. This was stated by Prof. Sulaiman A Khan a noted Orthopaedic Surgeon of the country. He was speaking at the concluding session of the Club Foot Ponseti technique workshop held at JPMC Karachi recently. It was organized by Prof. Anisuddin Bhatti, President of Pakistan Orthopaedic Association who is also the Chairman of Paediatric Orthopaedic Forum (South).


A view of the Club Foot Ponseti Workshop at JPMC.

The workshop was formally inaugurated by Prof. Ghulam Mahboob Dean JPMC. Speaking at the occasion he said that “nothing is better than conservative management of Club Feet, the results are unmatchable and lasting for life”. He stressed on Participants “to practice Ponseti technique they learn today & follow the principles otherwise there is no benefit of this exercise”. It was attended by 50 participants from all over Pakistan supervised by 12 faculty members. It consisted of lectures, video session and hands on training. The articulated foot and soft rubber foot models were prepared indigenously on “Ponseti international models”, along with foot abduction caliper, scotish night splints. Hands on training was given on teac manipulation techniques and casting technique, participant were also trained on application & maintenance of foot abduction splints which were applied on Rubber Baby models specially procured for this workshop. The live demonstration of manipulation technique was also made on patient’s. Participants themselves practiced steps of manipulation on articulated foot model as demonstrated by “Ponseti video” and taught during the lectures.
Dr. Mansoor Ali Khan from Indus Hospital in his presentation on “Pathoantomy” remarked that Professor Ignacio Ponseti at IOWA University USA spent his half life on dissecting the cadever Club feet & hips and evaluated on cinemetogrphy to understand patho anatomy of club feet. He invented Ponseti technique based on that cadever work and successfully achieved 95 – 90% results. Prof. Ghulam Mahboob, spoke on “Assessment and scoring of Club Feet” and highlighted the importance of assessment and scoring to plan treatment and predict the results before embarking on results of treatment.
Prof. Anis Bhatti spoke on “Ponseti technique step by step” and elaborated every step and principle and tried to make the participants understand the principles and steps of Ponseti technique. He also talked about articulated foot model. His main stress was on placement of fingers at specific point on Talar head instead of cal-caneocuboid joint and methods of manipulations with molding of casts. He described the Ponseti principle of “Coupled movement at sub later joint, fulculum at talonacular joints” and explained the importance of simultaneous correction at T. N. J & C. C. J. while elevating 1st Meta tarsal and abduction of fore foot.
Prof. Ayub Laghari from LUHMS, Jamshoroo Hydrabad spoke on follow up protocol & methodology of foot abduction Brace. Prof. Mujahid Humail from DUHS discussed the management principles of neglected and relapsed club feet. Dr. Mehtab Pirwani from LHUMS Jamshoro explained technique of Ilizarov correction of neglected older age club foot. Prof. Muhammad Idrees who was the Guest of honour stressed on proper maintenance of correction achieved with manipulation by proper use of feet abduction Brace without that recurrence is significant. (PR)

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