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Ponseti Casting in Obtaining Correction of Non-idiopathic Clubfoot: Where do we Stand? A Tertiary Care Institution-Based Prospective Observational Study

Original Article | Volume 12 | Issue 2 | May-August 2026 | Page: 8-14 | Prashant Adhikari, Jeevan Kumar Sharma, Gaurav Bir Bajracharya, Tarun Rajbhandari, Bibek Banskota, Saurav Neupane, Isha Amatya, Ashok Kumar Baskota DOI- https://doi.org/10.13107/ijpo.2026.v12.i02.270 Open Access License: CC BY-NC 4.0 Copyright Statement: Copyright © 2026; The Author(s). Submitted: 24/04/2026; Reviewed: 19/05/2026; Accepted: 20/06/2026; […]

Charting the Next Chapter: The Road Ahead for the International Journal of Paediatric Orthopaedics

Editorial | Volume 12 | Issue 2 | May-August 2026 | Page: 1-2 | Mandar Agashe DOI- https://doi.org/10.13107/ijpo.2026.v12.i02.266 Open Access License: CC BY-NC 4.0 Copyright Statement: Copyright © 2026; The Author(s). Authors: Mandar Agashe [1] [1] Department of Paediatric Orthopaedics, Director, Agashe Paediatric Superspeciality Clinic, Mumbai, Maharashtra, India. Address of Correspondence Dr. Mandar Agashe Department of […]

Ponseti Casting in Obtaining Correction of Non-idiopathic Clubfoot: Where do we Stand? A Tertiary Care Institution-Based Prospective Observational Study

Charting the Next Chapter: The Road Ahead for the International Journal of Paediatric Orthopaedics

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Ponseti Casting in Obtaining Correction of Non-idiopathic Clubfoot: Where do we Stand? A Tertiary Care Institution-Based Prospective Observational Study

DOI- https://doi.org/10.13107/ijpo.2026.v12.i02.270

Open Access License: CC BY-NC 4.0

Submitted: 24/04/2026; Reviewed: 19/05/2026; Accepted: 20/06/2026; Published: 10/08/2026

Authors: Prashant Adhikari [1,2], Jeevan Kumar Sharma [3], Gaurav Bir Bajracharya [1, 2], Tarun Rajbhandari [4, 5], Bibek Banskota [4, 5], Saurav Neupane [6], Isha Amatya [7], Ashok Kumar Baskota [4, 5]

[1] Department of Orthopaedics, Hospital for Advanced Medicine and Surgery, Kathmandu, Nepal.
[2] AaRuS Lifestyle Hospital, Kathmandu, Nepal,
[3] Indian Spinal Injuries Center, New Delhi, India,
[4] Department of Orthopaedics, Baidya and Banskota Hospital Pvt Ltd., Patan, Central Development Region, Nepal,
[5] Hospital and Rehabilitation Centre for Disabled Children, Orthopaedics, Banepa, Central Development Region, Nepal,
[6] Tribhuvan University Central Department of Rural Development, Kirtipur, Central Development Region, Nepal,
[7] Department of Orthopaedics, Patan Academy of Health Sciences, Lalitpur, Nepal.

Address of Correspondence

Dr. Prashant Adhikari,
Department of Orthopaedics, Hospital for Advanced Medicine and Surgery, Kathmandu, Nepal.
E-mail: adhikariprashant@hotmail.com

Abstract

Background: Clubfoot is a common congenital deformity, with idiopathic cases well managed by the Ponseti method. However, non‑idiopathic clubfoot (NICF), often associated with syndromic or neuromuscular conditions, remains challenging. Evidence on Ponseti casting in NICF is limited, and outcomes vary across etiologies.
Methods: This prospective observational study was conducted at a tertiary care center between September 2011 and September 2013. Out of 739 patients with clubfoot, 38 patients (59 feet) were diagnosed with NICF. Severity was assessed using Pirani and Diméglio scores. Ponseti casting was performed with weekly or accelerated cast changes, followed by Denis‑Browne splinting. Relapse and non-compliance were documented, and surgical interventions were tailored when casting failed.
Results: The majority of cases were due to Streeter’s dysplasia (36.9%) and arthrogryposis multiplex congenita (23.7%). All feet were rigid (Diméglio >5). Significant improvement in Pirani scores was observed across age groups (mean reduction from 5.2 ±1 to 2.9 ±1.4, P < 0.001). The mean number of casts required was 6.84, with Charcot‑Marie‑Tooth disease requiring the highest (13 casts). Correction was achieved in 61.7% of feet with casting ± heel cord release, while 38.3% required surgery. Relapse occurred in 18.9% of feet, mostly linked to splint non-compliance (31.6%). Parent‑reported satisfaction was high (78.9%).
Conclusion: Ponseti casting provides a reasonable success rate (61%) in NICF, particularly in younger age groups, and should be considered a first‑line treatment before surgical intervention. Despite higher rigidity and relapse rates compared to idiopathic cases, functional and cosmetic outcomes were satisfactory, with minimal complications.
Keywords: Dimeglio grading, non-idiopathic clubfoot, ponseti casting, pirani score, secondary clubfoot.

References

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How to Cite this Article: Adhikari P, Sharma JK, Bajracharya GB, Rajbhandari T, Banskota B, Neupane S, Amatya I, Baskota AK Ponseti Casting in Obtaining Correction of | Non-idiopathic Clubfoot: Where do we Stand? A Tertiary Care Institution-Based Prospective Observational Study | International Journal of Paediatric Orthopaedics | May-August 2026; 12(2): 08-14.

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Charting the Next Chapter: The Road Ahead for the International Journal of Paediatric Orthopaedics

DOI- https://doi.org/10.13107/ijpo.2026.v12.i02.266

Open Access License: CC BY-NC 4.0

Authors: Mandar Agashe [1]

[1] Department of Paediatric Orthopaedics, Director, Agashe Paediatric Superspeciality Clinic, Mumbai, Maharashtra, India.

Address of Correspondence

Dr. Mandar Agashe
Department of Paediatric Orthopaedics, Director, Agashe Paediatric Superspeciality Clinic, Mumbai, Maharashtra, India.
E-mail: mandarortho@gmail.com

Editorial

It is both a privilege and a responsibility to take over as Editor-in-Chief of the International Journal of Paediatric Orthopaedics (IJPO). I would like to begin by placing on record my deep gratitude to Dr. Jayanth Sampath, whose six years of dedicated stewardship gave this journal its identity, credibility, and steady growth. The strong editorial foundation he leaves behind is the platform on which we now build.
As I look ahead to the next three years, three themes will define our journey: relevance in the age of artificial intelligence, competitiveness amid a rapidly expanding field of specialty journals, and a structured push toward international indexing.
Staying relevant in the age of AI. Artificial intelligence is transforming how research is conceived, written, reviewed, and consumed. Rather than viewing this as a threat, IJPO must position itself as a thoughtful adopter — using AI-assisted tools to strengthen peer review quality, detect plagiarism and data manipulation, and speed up manuscript handling, while firmly safeguarding the human judgement and ethical oversight that no algorithm can replace. We will also encourage authors to engage critically with AI’s growing role in paediatric orthopaedic research and practice, through invited reviews and structured debates on the subject.
Standing out among emerging journals. The paediatric orthopaedic literature landscape is more crowded than ever, with new regional and subspecialty journals competing for the same pool of quality manuscripts. Our response will not be to chase volume, but to sharpen identity — prioritising manuscripts with genuine clinical relevance to low- and middle-income settings, encouraging multicentre Indian and South Asian collaborative studies, and building thematic issues around underrepresented areas such as neuromuscular disorders, limb deformity correction, and untreated or neglected paediatric trauma. A journal’s relevance is ultimately earned through the quality and originality of what it publishes, not merely its frequency.
The path to indexing. Perhaps the most tangible goal of my tenure will be to work systematically toward indexing in Scopus, DOAJ, and ultimately PubMed. This is not a matter of a single application, but of consistent, verifiable quality over time: timely publication schedules, rigorous peer review, complete ethical documentation, robust editorial governance, and full compliance with international publishing standards. I intend to work closely with the editorial board, reviewers, and the Paediatric Orthopaedic Society of India to ensure every issue reflects the standards these indexing bodies expect, so that when we apply, our application reflects years of consistent practice rather than a last-minute effort.
It is fitting that my first issue as Editor-in-Chief already reflects much of what I hope the journal will stand for. This edition brings together ten articles spanning the breadth of our subspecialty — from musculoskeletal infections and clubfoot to tumours and non-unions — offering readers a genuinely comprehensive snapshot of contemporary paediatric orthopaedic practice. Equally significant is the geographic spread of contributions, with authors writing from Africa and Nepal alongside India, a reminder that the challenges and innovations in our field are not confined by borders. This diversity of both content and contributors is exactly the direction in which I hope to steer IJPO — a journal that is international not merely in name, but in the voices it publishes.
None of this is achievable without the continued trust of our authors, the rigour of our reviewers, and the guidance of our editorial board. I look forward to working with this community over the next three years, and I invite members, authors, and readers to share their ideas as we shape this journey together.
The story of IJPO’s next chapter is one we will write collectively.

How to Cite this Article: Agashe M. Charting the Next Chapter: The Road Ahead for the International Journal of Paediatric Orthopaedics. International Journal of Paediatric Orthopaedics. May-August 2026; 12(2): 01-02.

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