5 Important Facts About Treating Clubfoot with the Ponseti Method

Published By LuskinOIC Foundation 11/20/2023

What is the Ponseti method and why is it important?

Coined by Dr. Ignacio Ponseti more than 60 years ago, the Ponseti method is still relevant today helping many children with clubfoot. The Ponseti method is a technique in which the foot is gently manipulated and casted every week during a 4-to-8-week period, allowing the muscles and ligaments to stretch and the bones to achieve a corrected position.

Here are 5 interesting facts about the Ponseti method and how it is used to help clubfoot:

1. Manipulation and Casting:

· Initial Assessment: The process begins with a thorough assessment of the baby’s clubfoot. The foot is gently manipulated to assess its flexibility and to understand the severity of the deformity.

· Gentle Manipulation: The foot is gently manipulated into a corrected position. The healthcare provider does not force the foot but rather guides it gradually to allow the muscles, ligaments, and bones to adapt naturally.

· Casting: After each manipulation, the foot is placed in a cast to maintain the amount of correction achieved. The cast is typically made of plaster or fiberglass. The casting is done in a way that gradually improves the foot’s position with each cast change.

· Weekly Cast Changes: The cast is changed weekly, and during each change, the foot is gently manipulated a bit further toward the correct position. This gradual process allows for the correction of the deformity over several weeks.

2. Achilles Tenotomy:

· Indications: After several weeks of casting, there might be residual tightness in the Achilles tendon preventing a complete correction of the deformity. If that is the case, the Achilles tendon is cut to complete the correction.

· Minor Procedure: Achilles tenotomy is a minor surgical procedure performed under local anesthesia. It involves a small incision on the back of the ankle. The Achilles tendon is cut, allowing it to lengthen and facilitating further correction of the foot’s position.

· Healing: Following the procedure, the baby’s foot is re-casted for a few weeks to allow the tendon to heal in the lengthened position.

3. Bracing:

· Purpose: Bracing is crucial for maintaining the corrected position of the foot.

· Types of Braces: Mitchell-Ponseti or similar braces are commonly used. These braces are designed to keep the foot in the corrected position.

· Bracing Regimen: The braces are worn full-time (23 hours a day) for a period of 3 months. After that, braces are worn during nap and night time to prevent relapses. Depending on the severity of the clubfoot, up to 5 years of bracing might be necessary.

· Importance of Compliance: Adherence to the bracing regimen is vital. Parents are educated on proper bracing techniques, and regular follow-up appointments with the healthcare provider ensure that the braces are fitting well and the correction is maintained.

4. Follow-up Care:

· Regular Monitoring: At LuskinOIC, the child’s progress is monitored through regular follow-up appointments with an orthopedic specialist experienced in the Ponseti method.

· Adjustments: During follow-up visits, the orthopaedic specialist experienced in the Ponseti method assesses the foot’s development and makes any necessary adjustments to the bracing regimen to ensure the correction is maintained as the child grows.

5. Physical Therapy:

· Purpose: Physical therapy might be recommended to help the child develop strength and coordination in the corrected foot.

· Exercises: Therapists provide exercises and activities to enhance the child’s motor skills and muscle strength, ensuring the corrected foot functions properly.

At LuskinOIC, each of these procedures is carefully tailored to the child’s specific condition and is conducted under the supervision of an orthopedic specialist experienced in the Ponseti method. The method’s success lies not only in the individual procedures but also in the comprehensive and personalized approach to each child’s unique needs.

Learn more about LuskinOIC’s specialized approach to treating clubfoot.