So, how do you fix clubfoot? The Ponseti method of clubfoot correction is a non surgical correction that involves a series of maneuvers to the foot that are performed by a skilled Ponseti method practitioner. These maneuvers are followed by casts that are changed weekly. Once the foot is corrected, the Ponseti method involves the application of a specialized abduction brace that is worn during the day from 3 to 24 months of age. Early treatment started shortly after birth seems to yield the best results for Ponseti method correction.
The Ponseti method is a relatively new method of clubfoot correction that is being used all over the world. From what we have learned, the Ponseti method is highly effective, even as successful as making the feet of children with clubfeet look and function normally! Ponseti correction is non-invasive, which means that most kids with clubfoot require little more than casting and bracing – a huge advancement over past methods that necessitated many painful surgeries with considerable risk of serious complications.
One of the key elements to the Ponseti method is the compliance of patients and their families in following the treatment protocol, particularly in the correct and consistent use of the brace to maintain the corrected foot position. If the brace is not worn as prescribed, the foot is likely to revert to its pre-treatment shape. As a result, great importance is placed on the education of families to ensure that they understand the necessity for brace wear.
Treating clubfoot with the Ponseti method has many benefits to children born with this congenital deformity. Research by López-Carrero et al. ( 2023) supports the fact that with this technique, the number of surgical interventions can be significantly reduced. Traditional treatments to correct clubfoot (such as posterior soft tissue release and spurs placement) often left children with decreased mobility and post-operative complications. The Ponseti method on the other hand successfully corrects clubfoot without surgery in the majority of cases and is beneficial for children’s long-term physical well-being.
Methods to correct club foot are simple and require trained hands but skilled hands and a knowledgeable health care team. Simple manipulations are done to the foot to prepare it for casting. Each week, as the child grows, the foot is further corrected in a series of casts until the foot is nearly corrected. This is one of the advantages of Ponseti method of treating club foot over surgical correction which involves cutting bones and reshaping them.
With patience and adherence to the brace protocol, families reap the rewards of the Ponseti method and thrive! While every family is unique and requires careful patience and adherence to the brace protocol, the Ponseti method has brought hope and success to thousands of families with children who have clubfoot. Their children will run, play, and live active lifestyles well into adulthood, thanks to timely correction, careful maintenance of correction, and a solid education of patients and their families on how to care for feet corrected by the Ponseti method. One of the advantages of the Ponseti method is the reduced potential for complications when compared to surgery. In fact, many doctors prefer the Ponseti method because of the decreased risk of medical complications to the child with clubfoot (Švehlík et al., 2017). By using manipulation and casting instead of surgery to correct the foot, the Ponseti method is in line with many current treatments and medical practices.
However, with traditional clubfoot treatments there is always a risk of serious complications, such as infection or inadequate healing. While Smith et al. (2014) found that most clubfoot surgery complications are relatively minor, they can still plague patients for years after treatment. But for many families with a child with clubfoot, the Ponseti method offers a safe, non-invasive alternative.
In addition to the other benefits of the Ponseti method, it is associated with improved functional outcomes and quality of life for children with club feet. Rastogi and Agarwal (2021) reported that children who had club feet corrected with Ponseti method walked normally as they grew older and participated in sports or physical activities which prevented them from developing low-socio emotional well-being because they had good quality of life and had several social interactions due to their high self-esteem.
The Ponseti method for treatment of club feet has spread worldwide, and adopted by many orthopedic doctors. Today it is accepted method in many countries. The method is relatively simple to apply, it brings fast effective results, and patients’ and parents’ testimonies promote it. The method is simple to learn and perform, for novice and experienced physicians alike. By teaching this method, it is possible to standardize treatment protocol of club feet, and its implementation in various health care systems. Moreover, Ponseti method can be easily and successfully applied in low tech, lower resource settings.
This method does not need any complex technology and with a few not so expensive equipment it can be practiced all over the world including underdeveloped countries where there are few health facilities and thus children with clubfoot can be treated easily and early enough.
The Ponseti method, when applied correctly, results in excellent non-invasive correction of clubfoot deformity, lower risk of major complications, and improved long-term outcomes. Children with clubfoot treated with the Ponseti method can expect to walk independently, participate in sports, and maintain better functional foot outcomes compared to children undergoing early clubfoot surgery (Sekirka et al., 2015). Acceptance and applicability of the Ponseti method for clubfoot treatment continue to positively impact families around the world with children born with clubfoot. , Long-term outcomes for patients treated with the Ponseti method are very encouraging. The studies reviewed reveal that most children have correction of clubfoot deformity achieved with parental satisfaction with the Ponseti method (Zhao et al., 2014). For these children with clubfoot, correction of the foot deformity, aesthetic appearance of the foot, and physical functionality allow for appropriate footwear choices, independence in gait, and participation in activities of growing children. This makes the Ponseti method the preferred, non-surgical treatment of clubfoot deformity for most families.
Although the data demonstrates great promise in clubfoot correction, relapse can occur as children age. Thomas et al. (2019) noted that relapse is more likely to occur as the child gets older. Thankfully, relapse that occurs in patients treated with the Ponseti method can generally be treated with more casting, and surveys by Hosseinzadeh et al. (2019) indicate that most families report being able to manage relapse without requiring further surgical intervention.
PAARA’s Ponseti method is a less invasive treatment for club feet compared to traditional surgical methods. Serious complications from surgery include infections, permanent external and internal scars, and long recovery times. The Ponseti method for club feet treatment involves straightening the foot through manipulation and casting. Not only does it treat the club foot, but it tends to have fewer long-term complications than surgery. This is why many families choose PAARA for club feet treatment.
Although the long-term followup data are still accumulating, the available studies provide encouraging results following the Ponseti method for clubfoot correction. Many children can expect to walk and have a nearly normal range of motion as they grow into adulthood. In addition, relapses are corrected non-surgically with similar technique leading to ongoing active and healthy lifestyles. With more research now complete, the Ponseti method has earned its place in clubfoot treatment with optimistic results for families.
Citations:
Ganesan, B., Luximon, A., Al-Jumaily, A., Balasankar, S.K. and Naik, G.R., 2017. Ponseti method in the management of clubfoot under 2 years of age: A systematic review. PloS one, 12(6), p.e0178299. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0178299
Maghfuri, H.B., Alshareef, A.A. and Alshareef, A., 2024. The efficacy of the Ponseti method in the management of clubfoot: a systematic review. Cureus, 16(1). https://www.cureus.com/articles/204991-the-efficacy-of-the-ponseti-method-in-the-management-of-clubfoot-a-systematic-review.pdf
López-Carrero, E., Castillo-López, J.M., Medina-Alcantara, M., Domínguez-Maldonado, G., Garcia-Paya, I. and Jiménez-Cebrián, A.M., 2023. Effectiveness of the Ponseti method in the treatment of clubfoot: a systematic review. International Journal of Environmental Research and Public Health, 20(4), p.3714. https://www.mdpi.com/1660-4601/20/4/3714
Hosseinzadeh, P., Kiebzak, G.M., Dolan, L., Zionts, L.E. and Morcuende, J., 2019. Management of clubfoot relapses with the Ponseti method: results of a survey of the POSNA members. Journal of pediatric orthopaedics, 39(1), pp.38-41. https://journals.lww.com/pedorthopaedics/FullText/2019/01000/Management_of_Clubfoot_Relapses_With_the_Ponseti.18.aspx
Rastogi, A. and Agarwal, A., 2021. Long-term outcomes of the Ponseti method for treatment of clubfoot: a systematic review. International Orthopaedics, 45(10), pp.2599-2608. https://link.springer.com/article/10.1007/s00264-021-05189-w
Švehlík, M., Floh, U., Steinwender, G., Sperl, M., Novak, M. and Kraus, T., 2017. Ponseti method is superior to surgical treatment in clubfoot–Long-term, randomized, prospective trial. Gait & Posture, 58, pp.346-351. https://www.sciencedirect.com/science/article/pii/S0966636217308457
Shabtai, L., Specht, S.C. and Herzenberg, J.E., 2014. Worldwide spread of the Ponseti method for clubfoot. World journal of orthopedics, 5(5), p.585. https://pmc.ncbi.nlm.nih.gov/articles/PMC4133465/
Smith, P.A., Kuo, K.N., Graf, A.N., Krzak, J., Flanagan, A., Hassani, S., Caudill, A.K., Dietz, F.R., Morcuende, J. and Harris, G.F., 2014. Long-term results of comprehensive clubfoot release versus the Ponseti method: which is better?. Clinical Orthopaedics and Related Research®, 472(4), pp.1281-1290. https://link.springer.com/article/10.1007/s11999-013-3386-8
Zhao, D., Li, H., Zhao, L., Liu, J., Wu, Z. and Jin, F., 2014. Results of clubfoot management using the Ponseti method: do the details matter? A systematic review. Clinical Orthopaedics and Related Research®, 472(4), pp.1329-1336. https://link.springer.com/article/10.1007/s11999-014-3463-7
Thomas, H.M., Sangiorgio, S.N., Ebramzadeh, E. and Zionts, L.E., 2019. Relapse rates in patients with clubfoot treated using the Ponseti method increase with time: a systematic review. JBJS reviews, 7(5), p.e6. https://journals.lww.com/jbjsreviews/fulltext/2019/05000/Relapse_Rates_in_Patients_with_Clubfoot_Treated.3.aspx
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