Long-Term Comparative Results in Patients With Congenital Clubfoot Treated With Two Different Protocols

Does Strict Adherence to the Ponseti Method Improve Isolated Clubfoot Treatment Outcomes? A Two-institution Review

“…Popular treatment options include primary soft tissue release surgery and the Ponseti method of clubfoot manipulation and serial casting [7,12,13]. The Ponseti method is associated with fewer surgical revisions [12], decreased cost [13], and most importantly, better long-term functional outcomes compared with primary soft tissue release surgery [16]. However, the Ponseti method has been used with varying degrees of success across institutions [3, 8-12, 15, 17, 21, 24, 26, 28, 33].…”

“…The Ponseti technique has been reported to yield successful rates without significant surgical events in upward of 95% of patients [21,27]. Although proponents of the Ponseti technique have reported it is ''easy to learn'' [29], costeffective [13], and results in better long-term function compared with surgical intervention [1,15,16,33], Ponseti noted that strict adherence to his fundamental principles were essential for success [23]. Based on the comparison of a group of clubfeet treated with the Ponseti method to a historical control group treated with traditional conservative casting methods, Herzenberg et al [15] reported that traditional conservative casting techniques were more likely to result in incomplete clubfoot correction.…”

Ponseti Treatment for Idiopathic Clubfoot: Minimum 5-year Followup

“…Other authors have reported short-term results with the Ponseti technique. Ippolito et al [18] compared babies treated with different protocols (Ponseti and the Marino-Zuco method). In the Ponseti group, 78% of the feet had excellent or good results as compared with only 43% feet in the non-Ponseti group.…”

Update on Clubfoot: Etiology and Treatment

“…Even though extensive soft tissue release operations can provide definitive correction, there are many reported short-term complications including incomplete corrections, overcorrections, as well as neurovascular injuries [2,73]. The few long-term followup studies that are available on clubfeet treated with extensive soft tissue releases illustrate that the results often deteriorate with time [1,21,36,37]. Reported long-term complications include stiffness of the ankle and subtalar joints [21,37], arthritis [21,37], muscle weakness [1,21,37], pain [21,37], and residual deformity [1,21,37].…”