Related Experiment Video
Updated: Jun 26, 2026
Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
Ponseti treatment for idiopathic clubfoot: minimum 5-year followup
Noam Bor1, Julie A Coplan, John E Herzenberg
1Pediatric Orthopedic Unit, Emek Medical Center, Afula, Israel.
Insights
The Ponseti method effectively treats clubfoot, even with late intervention. Good brace compliance is crucial for successful outcomes and reduces the need for further surgery.
Area of Science:
- Orthopedics
- Pediatric Orthopedics
- Podiatry
Background:
- Ponseti method for clubfoot treatment has gained popularity.
- Review of medical records for 74 infants (117 club feet) treated with Ponseti method.
- Minimum follow-up of 5 years.
Purpose of the Study:
- Evaluate the effectiveness of Ponseti treatment for clubfoot.
- Identify factors influencing treatment outcomes.
- Assess long-term results including ankle motion and parent satisfaction.
Main Methods:
- Retrospective review of patient records.
- Analysis of age at presentation, previous treatments, Pirani severity score, cast numbers, tenotomy, and surgical procedures.
- Measurement of final ankle motion and parent perception of outcome.
- Study categorized as Level IV therapeutic study.
Main Results:
- Late presentation and prior non-Ponseti treatment correlated with lower initial severity and fewer casts.
- Good brace use (75% in late presenters) predicted fewer extensive surgical procedures.
- 32% of patients required additional surgery beyond tenotomy.
- 89% of feet achieved adequate dorsiflexion at follow-up.
- Parent satisfaction was high, independent of ankle motion.
Conclusions:
- The Ponseti method is effective for clubfoot, regardless of late initiation or prior treatment failures.
- Adherence to bracing significantly influences treatment success and minimizes surgical intervention.
- The study highlights the importance of consistent brace use for optimal clubfoot management.
Unlabelled:
Ponseti clubfoot treatment has become more popular during the last decade. We reviewed the medical records of 74 consecutive infants (117 club feet) who underwent Ponseti treatment. Minimum followup was 5 years (mean, 6.3 years; range, 5-9 years). We studied age at presentation, previous treatment, the initial severity score of the Pirani scoring system, number of casts, need for Achilles tenotomy or other surgical procedures, and brace use. We measured final ankle motion and parents' perception of outcome. Late presentation and previous non-Ponseti treatment were associated with lower initial severity score, fewer casts, and less need for tenotomy. Forty-four percent of patients had poor brace use. We observed better brace use (75%) in babies who presented late for treatment. Good brace use predicted less need for extensive surgical procedures. Twenty-four (32%) babies underwent additional surgical procedures other than tenotomy, including 21% who underwent tibialis anterior tendon transfer. At followup, 89% of feet had adequate dorsiflexion (5 degrees or greater). Parents indicated high satisfaction with the treatment results. Ankle motion was not associated with parents' satisfaction. The Ponseti method is effective, even if treatment starts late or begins after failure at other centers. Brace use influenced the success of treatment.
Level Of Evidence:
Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.