Ponseti Method Applications in Clubfoot Management
Summary
The Ponseti method is a globally adopted conservative approach for the correction of congenital talipes equinovarus (clubfoot). It comprises gentle manipulation of the foot followed by the application of a series of well-moulded casts to gradually realign the bony structures, a percutaneous Achilles tenotomy to address residual equinus, and prolonged use of a foot abduction brace to maintain correction. Since its development in the mid-20th century, the method has transformed clubfoot care by minimising extensive soft-tissue release surgeries and delivering high rates of plantigrade, functional feet. Its simplicity, cost-effectiveness and reproducibility have facilitated widespread implementation across diverse healthcare settings, including low- and middle-income countries. Recent adaptations address challenges such as brace compliance, relapse management and treatment of non-idiopathic cases in arthrogryposis or neuromuscular syndromes. Continuous refinements in casting materials, caregiver education programmes and dynamic orthotic designs have further enhanced long-term outcomes and patient satisfaction.
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Ponseti Method Applications in Clubfoot Management publication trend
The graph below shows the total number of articles in ponseti method applications in clubfoot management across all publications each year (not limited to Nature Index journals).
Technical terms
Ponseti method: A stepwise treatment involving serial manipulation, casting, percutaneous Achilles tenotomy and bracing to correct clubfoot.
Percutaneous Achilles tenotomy: A minimally invasive procedure to release a tight Achilles tendon and restore ankle dorsiflexion.
Foot abduction brace: An orthotic device holding corrected feet in external rotation and dorsiflexion to prevent relapse.
Pirani score: A clinical scoring system (0–6) assessing the severity of clubfoot deformity based on midfoot and hindfoot contracture.
Relapse: The reappearance of any component of clubfoot deformity after initial correction.
References
- Ponseti method in the management of clubfoot under 2 years of age: A systematic review. PLOS ONE (2017).
- A comprehensive outcome comparison of surgical and Ponseti clubfoot treatments with reference to pediatric norms. Journal of Children's Orthopaedics (2012).
- Improved bracing compliance in children with clubfeet using a dynamic orthosis. Journal of Children's Orthopaedics (2009).
- Ponseti method compared to previous treatment of clubfoot in Norway. A multicenter study of 205 children followed for 8–11 years. Journal of Children's Orthopaedics (2016).
- Factors Related to Early Recurrence of Idiopathic Clubfoot Post the Ponseti Method. Malaysian Orthopaedic Journal (2019).
- The effectiveness of the Ponseti method for treating clubfoot associated with arthrogryposis: Up to 8 years follow-up. Journal of Children's Orthopaedics (2016).
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