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[Treatment of congenital clubfoot with the Ponseti method]
1Department of Orthopedics and Traumatology (Ortopedi ve Travmatoloji Anabilim Dali), Medicine Faculty of Istanbul University, 34390 Capa, Turkey. sbgoksan@e-kolay.net
Insights
The Ponseti method effectively corrects idiopathic congenital clubfoot deformities in infants. Strict adherence to the technique and proper use of a foot abduction brace are crucial for successful outcomes and preventing relapses.
Area of Science:
- Orthopedics
- Pediatric Orthopedics
- Podiatry
Background:
- Idiopathic congenital clubfoot is a common birth defect requiring effective treatment.
- The Ponseti technique offers a non-surgical approach to clubfoot correction.
- Evaluating early experiences with the Ponseti method is essential for refining treatment protocols.
Purpose of the Study:
- To present early experiences with the Ponseti technique for clubfoot correction.
- To assess the necessity of aggressive surgical interventions in the first year of life.
- To evaluate the efficacy of the Ponseti method in treating various grades of idiopathic clubfoot.
Main Methods:
- The study included 31 patients (44 feet) with idiopathic clubfoot (grades II-IV).
- Patients underwent manipulation casting per the Ponseti technique, with percutaneous Achilles tenotomy for persistent equinus.
- A foot abduction brace was used for maintaining correction, with a mean follow-up of 18 months.
Main Results:
- The Ponseti method achieved successful correction in 95% (42 feet) of cases.
- Patients with prior conservative treatment showed higher compliance with the foot abduction brace.
- No aggressive surgical intervention was required in this cohort during the first year.
Conclusions:
- The Ponseti method is highly effective for idiopathic congenital clubfoot, regardless of initial deformity grade, when technique is strictly followed.
- Consistent use of the foot abduction brace is vital for preventing relapses.
- Enhancing patient compliance through education and experienced orthotists is key to long-term success.
Objectives:
This study aimed to present the author's early experience with the Ponseti technique in correcting clubfoot and to evaluate the need for aggressive surgery in the first year of life.
Methods:
The study included 44 feet of 31 patients (25 boys, 6 girls; mean age 3 months; range 4 days to 8 months) with idiopathic clubfoot deformities of grade II, III, or IV. Twenty-seven feet (19 patients) had not received any treatment before. Twelve patients (17 feet) had had unsuccessful prior conservative treatment elsewhere. All patients had manipulation casting in accordance with the Ponseti technique, and percutaneous Achilles tenotomy was performed in the presence of persistent equinus. Maintenance of correction was obtained with the use of a foot abduction brace. The mean follow-up period was 18 months (range 6.5 to 40 months).
Results:
Forty-two feet (95%, 29 patients) were treated successfully using the Ponseti method. In terms of compliance with the foot abduction brace, a significant difference was noted between patients without previous treatment and those with deformities considered resistant to prior conservative treatment. The latter manifested more compliance with brace application.
Conclusion:
Ponseti method proved efficient in correcting idiopathic congenital clubfoot deformities irrespective of initial deformity grades, provided that the details of the technique are strictly adhered to. The results also suggest the role of brace application in order to avoid relapses along with the importance of increasing patients' compliance through family education and experienced orthotists.
