Sixty Years On: Ponseti Method for Clubfoot Treatment Produces High Satisfaction Despite Inherent Tendency to Relapse

Area of Science:

• Orthopedics
• Pediatric Orthopedics
• Medical Research

Background:

• The Ponseti method, developed in 1950 for idiopathic clubfoot, gained widespread acceptance in the mid-1990s.
• Limited intermediate and long-term outcome studies exist, with most originating from a single institution.
• This study aims to provide contemporary outcome data for the Ponseti method in clubfoot management.

Purpose of the Study:

• To report the outcomes of patients with idiopathic clubfoot treated with the Ponseti method.
• To establish outcome expectations for parents and clinicians managing clubfoot.
• To evaluate intermediate-term results of the Ponseti method for clubfoot deformity.

Main Methods:

• Prospective study of infants diagnosed with idiopathic clubfoot since July 2006.
• Inclusion criteria: no prior outside treatment, minimum follow-up to age 5.
• Data collection included demographics, treatment details, and outcomes using Dallas criteria and Roye disease-specific instrument (DSI).

Main Results:

• 101 patients met inclusion criteria with a mean follow-up of 81.1 months.
• Initial correction achieved in all feet; 68% experienced at least one relapse.
• 62% had good outcomes per Dallas criteria; 38% underwent tendon transfer; families reported high satisfaction with Roye DSI.

Conclusions:

• The Ponseti method yields satisfactory intermediate-term results for idiopathic clubfoot.
• Anterior tibial tendon transfer remains a crucial adjunct, even with improved understanding of the Ponseti method.
• Consistent adherence to post-corrective bracing is critical for successful clubfoot management.