Ponseti technique for the correction of idiopathic clubfeet presenting up to 1 year of age. A preliminary study in children with untreated or complex deformities

Abstract

Our results show that the Ponseti technique is reproducible and effective in children at least up to 12 months of age. It can also produce good correction in children presenting with complex idiopathic deformities. Therefore, extensive joint releases should not be considered immediately in such cases. The treating surgeon should be meticulous in using the technique and ensure compliance to foot abduction brace in order to avoid recurrences.

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

“…Bor et al [2] observed that deviations from the Ponseti bracing recommendations were associated with a near twofold increase in additional operations. Excessive weight gain [4], parental educational level [8,12], a positive family history [8,12], and bracing noncompliance [8,9,11,21,28,31] have been identified as patient-related predictors of treatment failure.…”

“…If untreated, this compromised foot position can result in long-term pain and severe disability [3,9]. Conservative treatment attempts to correct the deformity such that the foot is functional, pain-free, flexible, and able to fit in regular shoes [22,23].…”

Ponseti Method for Untreated Idiopathic Clubfeet in Nepalese Patients From 1 to 6 Years of Age

“…Abduction splinting is an essential component of the Ponseti method, and relapse rates of up to 70% may be expected when the abduction splint is not worn [6,10,11,27]. Reasons for a lack of adherence to the splinting program may include noncompliance (patient or family chooses not to wear the splint) and brace intolerance (discomfort from skin irritation or other cause).…”

Congenital constriction ring syndrome with foot deformity: two case reports

“…They were 6 and 8 months old respectively. Although clubfeet associated with congenital annular constricting bands are rigid and treated with surgically in the previous reports, the Ponseti method of serial casting to gradually correct the deformity, combined with a percutaneous tenotomy of the Achilles tendon to correct ankle equinus followed by several years of bracing to maintain the correction, has gained widespread popularity in recent years for the treatment of idiopathic clubfoot and is becoming increasingly more widely used [9,10] and our successful results with this conservative method of Ponseti may prevent unnecessary operations in this patient group. Although the clubfeet in the present study were well corrected after 1 year of follow-up, longer follow-up is necessary to assess the continued risk of recurrence and to allow for more accurate recommendations regarding the length of time necessary for brace wear.…”