COMPARATIVE ANALYSIS OF EFFECTIVENESS OF TREATMENT METHODS FOR CONGENITAL CLUBFOOT
The article analyzes the results of conservative treatment of congenital clubfoot in 419 patients using the technique by Zatsepin, the technique proposed by I. Yu. Klychkova (Russian Patent N 02387396) and the Ponseti method. The absolute advantage of the Ponseti method has been established: successful treatment was carried out in 92.5% of patients relative to 38.1% according to the Zatsepin method and 50% according to the method proposed by Klychkova. Thus, treatment using the Ponseti method allows to avoid additional surgery in 74.4% of patients with a IV degree of deformity. A statistically significant decrease in the total duration of stay for serial casting according to the Ponseti method relative to the Zatsepin method was shown: 54.2 ± 0.79 versus 83.6 ± 1.37 days. The Ponseti method, used as a preoperative preparation in preschool children with recurrent clubfoot, reduces the need to use the Ilizarov device in the postoperative period from 61.2 to 15.8%, which is statistically significant. The duration of the hospital stay is reduced by almost 70%. The Ponseti method, along with high effictiveness, meetsthe principle of minimally invasive technique, allowing to reduce the amount of surgical interventions, in most cases, up to transposition of the anterior tibial muscle. It has an established algorithm, it can be standardized, and should find a wider practical application(6 figs, 4 tables, bibliography: 23 refs).