Ponseti Method - Non-Surgical Clubfoot Treatment
UW Health's pediatric orthopedic program at American Family Children's Hospital in Madison, Wisconsin provides world-class care for children, adolescents and young adults with all types of musculoskeletal disorders.
If your child is born with clubfoot, your doctor might recommend a casting process to begin to correct the feet, followed by major reconstructive surgery.
Offering an alternative to once-standard surgical treatment that often leads to mobility and stiffness problems later in life, the American Family Children's Hospital offers a technique known as the "Ponseti Method."
Specific, Gentle Foot Manipulation
Rather than moving the bones in the clubfoot surgically, the Ponseti method calls for a very specific manipulation of the foot to stretch the contracted tissues. A cast is then applied to maintain the correction and the foot is held in the corrected position for approximately seven days, allowing the muscles and ligaments to stretch enough to make further correction possible. The cast is then removed and another process of gentle massage and manipulation is repeated.
The casting process can take three to four months. Then the baby is fitted with shoes attached to a metal bar that must be worn 24 hours a day for about six months, and then at night until the child is three or four years old. So in order for the technique to be successful, parents must be dedicated to maintaining the correction obtained through casting by adhering to orthosis at home.
"Tune-Up Surgery" Possible
When the Ponseti approach is used, only about one percent of patients will require a major operation on the affected feet.
In about one-third of the Ponseti patients, slight residual deformities may emerge at age two or three, requiring what can be characterized as a "tune-up surgery" in which a tendon may be transferred or lengthened. The procedure is much less drastic than the major clubfoot surgery that would be necessary without the Ponseti method.
Flexibility and Mobility Later in Life
Though it was developed more than 50 years ago by Dr. Ignacio Ponseti at the University of Iowa, the Ponseti method has only recently taken hold outside of Iowa.
Since the mid-1990s, Ponseti's work has been bolstered by studies showing that the feet of children treated with the Ponseti method are generally more supple, flexible and mobile than the feet of patients that underwent major surgery to correct clubfoot deformities.