Use of a Ponseti-hex Assisted Triple Arthrodesis: A Case Study of Bilateral Neglected Adult Clubfoot

Management of neglected clubfoot presents a challenging problem. Treatments traditionally involve extensive posteromedial soft tissue releases, bony procedures, and the Ilizarov technique of differential distraction.

We present a case of bilateral neglected clubfoot in a 34-year-old female. Management involved the novel combination of the gradual distraction of prepared triple arthrodesis surfaces and the Ponseti regimen which was achieved using the three-dimensional corrective power of hexapod-type circular fixators. Both feet were corrected to achieve plantigrade painless feet.

Combining the Ponseti regimen with a hexapod fixator has presented an excellent management strategy for neglected clubfeet in an adult. We further propose the use of a generic name, the Ponseti-hex technique, to cover for the use of all makes of hexapod external fixators.