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[Clubfoot treatment: Implementation of the Ponseti method in emerging countries]
F Vigouroux1, A Bertani1, V Cunin2
1Service de chirurgie orthopédique et traumatologique, hôpital d'instruction des armées Desgenettes, 108, Boulevard Pinel, 69003 Lyon, France.
Insights
The Ponseti method effectively treats idiopathic clubfoot using casting and bracing. This study identifies barriers to its use in resource-limited settings and suggests improvements for wider adoption, even by non-physicians.
Area of Science:
- Orthopedics
- Pediatric Surgery
- Public Health
Background:
- Idiopathic clubfoot is a common congenital deformity globally.
- The Ponseti method is the established gold standard for clubfoot treatment.
- This method is cost-effective and suitable for resource-limited healthcare systems.
Purpose of the Study:
- To identify key barriers hindering the widespread adoption of the Ponseti method.
- To propose actionable improvements for enhancing the method's implementation.
- To emphasize critical aspects for effective utilization by non-physician healthcare providers.
Main Methods:
- Review of existing literature on Ponseti method implementation.
- Analysis of reported challenges in resource-limited settings.
- Development of recommendations based on identified barriers and best practices.
Main Results:
- Barriers include lack of training, inadequate resources, and poor patient compliance.
- Internet accessibility has aided diffusion but not eliminated challenges.
- Effective utilization requires standardized training and community support.
Conclusions:
- The Ponseti method's effectiveness is well-established, but its global reach is limited by specific barriers.
- Addressing these barriers through targeted improvements and training is crucial for wider success.
- Empowering non-physicians can significantly improve treatment access for idiopathic clubfoot worldwide.
Abstract:
Idiopathic clubfoot is one of the most frequent congenital deformities throughout the world. The Ponseti method is the gold standard for its treatment. This simple, low-cost method is very effective and very appropriate for countries with resource-limited or otherwise precarious health services. It is based on correction of the deformity by successive castings associated with a percutaneous Achilles tenotomy and then foot abduction bracing to maintain the correction. The Ponseti method is now well implemented in most emerging countries, largely due to internet development, but some barriers still limit its diffusion. This study aims to determine the principal barriers, to suggest some improvements, and to stress the essential points of its effective utilization by non-physicians.
