Good results with the Ponseti method

Abstract

Background and purposeIn 2002–2003, several hospitals in Norway introduced the Ponseti method for treating clubfoot. The present multicenter study was conducted to evaluate the initial results of this method, and to compare them to the good results reported in the literature.Patients and methods116 children with 162 congenital idiopathic clubfeet who were born between 2004 and 2006 were treated with the Ponseti method at 8 hospitals in Norway. All children were prospectively registered at birth, and 116 feet were assessed according to Pirani before treatment was started. 63% used a standard bilateral foot abduction brace, and 32% used a unilateral above-the-knee brace. One of the authors examined all feet at a mean age of 4 years. At follow-up, all feet were assessed by Pirani’s scoring system, and range of motion of the foot and ankle was measured.ResultsAt follow-up, 77% of the feet had a Pirani score of 0.5 or better, good dorsiflexion and external rotation, and no forefoot adduction. An Achilles tenotomy had been performed in 79% of the feet. Compliance to any brace was good; only 7% were defined as non-compliant. Extensive soft tissue release had been performed in 3% of the feet.We found no statistically significant differences between the two braces, except a tendency of better Pirani score in the group using the bilateral foot abduction brace, and a tendency of better compliance in patients using the unilateral brace. Better Pirani scores were found in children who were treated at the largest hospitals.InterpretationAfter introducing the Ponseti method in Norway, the clinical outcome was good and in accordance with the reports from single centers. Only 5 feet needed extensive surgery during the first 4 years of life.

Ponseti Casting for Severe Club Foot Deformity: Are Clinical Outcomes Promising?

“…We followed up the patients for 26 month, which is comparable with other studies assessing the Ponseti method [ 19 – 24 ]. The average age of our patients was 8 days.…”

“…The average age of our patients was 8 days. Other studies that were designed to follow up the patients at birth had the same average of 1 to 17 days [ 19 , 21 , 24 ]. Male to female patient ratio was similar to Panjavi et al's study [ 21 ], but it was higher than other studies such as Banskota et al [ 20 ] or Pavone et al's studies [ 19 ].…”

Manipulation and brace fixing for the treatment of congenital clubfoot in newborns and infants

“…Tand lead to normal appearance and function of the congenital clubfoot. The Ponseti technique does not disturb the normal physiological structure of the foot, has few long-term complications, and causes little trauma, which ensures the normal development of muscles, bones, and joints of the foot with deformity [ 15 ]. This method is also applicable in older children [ 16 ].…”

Worldwide spread of the Ponseti method for clubfoot

“…Since 1997, the efforts of Ponseti champions have led to a steady increase in clinical use and publication worldwide, especially over the last decade. This conservative method has been shown to be effective, safe, and cost-effective [5][6][7][8][9][10][11][12][13][14] . As this method is largely non-surgical, and requires only basic medical supplies, its potential to spread to both developed and undeveloped countries is unlimited.…”

“…Its safety and efficacy has been demonstrated extensively in the literature [5][6][7][8][9][10][11][12][13][14] . We performed a systematic review to determine the exact penetration of the Ponseti method worldwide, and to examine the factors that lead to this spread.…”