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Correction of neglected idiopathic club foot by the Ponseti method
1Department of Orthopaedics and Traumatology Federal University of São Paulo, Rua Napoleão de Barros, 715-04024-002 São Paulo, Brazil. alex.dot@uol.com.br
Insights
The Ponseti method effectively treats neglected clubfoot in children over two years old. This low-cost approach yields good results, often avoiding extensive surgery for older patients.
Area of Science:
- Orthopedics
- Pediatric Orthopedics
- Podiatry
Background:
- The Ponseti method is a standard treatment for infant clubfoot.
- Its efficacy in older children with neglected clubfoot is less understood.
Purpose of the Study:
- To evaluate the effectiveness of the Ponseti method in treating congenital idiopathic clubfoot in children presenting after walking age.
Main Methods:
- Retrospective review of 17 children (24 feet) with neglected idiopathic clubfoot treated with the Ponseti method.
- Mean age at presentation was 3.9 years; mean follow-up was 3.1 years.
Main Results:
- A painless plantigrade foot was achieved in 16 out of 24 feet without extensive surgery.
- Four patients (7 feet) required a second tenotomy for recurrent equinus.
- Five patients (8 feet) needed posterior release for complete correction.
Conclusions:
- The Ponseti method is a safe, effective, and low-cost treatment for neglected idiopathic clubfoot in children presenting after walking age.
- While generally successful, some cases may require additional interventions.
Abstract:
The Ponseti method of treating club foot has been shown to be effective in children up to two years of age. However, it is not known whether it is successful in older children. We retrospectively reviewed 17 children (24 feet) with congenital idiopathic club foot who presented after walking age and had undergone no previous treatment. All were treated by the method described by Ponseti, with minor modifications. The mean age at presentation was 3.9 years (1.2 to 9.0) and the mean follow-up was for 3.1 years (2.1 to 5.6). The mean time of immobilisation in a cast was 3.9 months (1.5 to 6.0). A painless plantigrade foot was obtained in 16 feet without the need for extensive soft-tissue release and/or bony procedures. Four patients (7 feet) had recurrent equinus which required a second tenotomy. Failure was observed in five patients (8 feet) who required a posterior release for full correction of the equinus deformity. We conclude that the Ponseti method is a safe, effective and low-cost treatment for neglected idiopathic club foot presenting after walking age.
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