The Ponseti method in Latin America: initial impact and barriers to its diffusion and implementation

Area of Science:

• Orthopedics
• Public Health
• Global Health

Background:

• Clubfoot is a common congenital foot deformity.
• The Ponseti method is a minimally invasive, effective treatment for clubfoot.
• Recent implementation of the Ponseti method in Latin America necessitates evaluation of its impact and barriers.

Purpose of the Study:

• To assess the initial impact of the Ponseti method in Latin America.
• To identify unique barriers to the widespread adoption of the Ponseti method in the region.
• To inform strategies for improving clubfoot treatment accessibility and outcomes.

Main Methods:

• Structured interviews with 30 physicians using the Ponseti method in Chile, Peru, and Guatemala.
• Analysis of treatment approaches for approximately 1,740 clubfoot patients.
• Thematic classification of identified barriers to treatment diffusion.

Main Results:

• Physicians treated 1,705 (98%) patients with the Ponseti method, with only 35 (2%) requiring surgery.
• Common barriers identified include insufficient physician education, long travel distances to treatment centers, and financial constraints for patients.
• Cultural beliefs and parental compliance also presented challenges.

Conclusions:

• The Ponseti method shows high efficacy in Latin America, with surgical intervention being rare.
• Addressing barriers in physician training, healthcare systems, patient finances, and logistics is crucial for successful implementation.
• Targeted strategies are needed to enhance the diffusion and accessibility of the Ponseti method for clubfoot treatment across Latin America.