I recently received a wonderful letter from the mother of a 10-month-old boy who had been born with a left clubfoot. She wanted to be sure I would let parents everywhere know about a gentle, effective solution to clubfoot that she found online - a method that she says can eliminate the need for major reconstructive surgery. The Ponseti technique that she refers to has been practiced continuously at the University of Iowa since 1948. But it remained relatively obscure until the rise of the Internet and the increased accessibility of medical information. Now, parents who look online before choosing treatment have become enthusiastic fans of the Ponseti method. And so have pediatric orthopedists, podiatrists, and pediatricians. The peer-reviewed medical literature has now confirmed the excellent results achieved with this technique, both gentler and more effective than other options, and demonstrated that the same results have been achieved at centers around the world. And even though the technique is designed to be started immediately after birth, a March 2006 study in Clinical Orthopaedics and Related Research found the technique successful even in children who had already failed casting by other doctors, or who delayed treatment more than three months. What a story! This is an example of how one visionary physician and many grateful parents can use the Internet to change the practice of medicine. Today, the overwhelming majority of children born with club feet can indeed have great results without the need for major reconstructive surgery. I am convinced that the Ponseti Method is a marvelous initial treatment for club foot. If I had a child with clubfoot, I would seek out someone skilled in this technique and get started right away.
I am grateful to the thoughtful mother who nudged me to get this information to you. She wrote, .Dr. Greene,…I found out about my son’s foot via ultrasound and researched treatment methods available prior to his birth. I came across an absolutely wonderful treatment method for clubfoot created by Dr. Ignacio Ponseti. The Ponseti Method is recognized by the American Academy of Pediatrics as the standard for clubfoot correction. It involves precise manipulation of the foot with casting (with cast changes done every 5-7 days) for a total of no more than 9 casts for even the most severe clubfoot. After this casting period a small nick is made to the Achilles tendon (done under local anesthesia - no sutures required), followed by another 3 weeks of continuous cast wear to hold correction and allow the tendon to heal in the stretched position. The child then wears a foot abduction brace 23 hours a day for three months with gradual reduction in hours thereafter until it is worn only during the night until approx. 4 years of age. This is such a wonderful method and virtually eliminates invasive surgery. It has a > 98% success rate when done correctly. Dr. Greene, I know your website is used by many parents seeking information on all sorts of different child issues. I, too, have used it to gather much info. I think by showing parents info on this method, it may save many children from having major surgery to treat something as simple as clubfoot. I am certain that by showing new parents out there who have a newborn child with clubfoot an alternative treatment method, you will have many grateful parents - not to mention happy children. Thank you for your time and consideration..
Actually, we thank you.
Alan Greene MD FAAP
| September 25th, 2006 at 10:39 am
I, too, learned about the Ponseti method via the Internet and was able to spare my daughter from the posterio-medial release (reconstructive surgery) that she was scheduled to undergo at six months of age to complete her correction. This was over 6 years ago, and at the time, the information on the Internet about the condition was very limited compared to what’s out there today. Luckily, I happened upon the information and once we switched to care under Dr. Ponseti, we never had to look back. He fixed her foot with just 4 casts. Today, my daughter is an active 6 year old first grader and no one would ever guess that she was born with a clubfoot.
Please update your main clubfoot information page with either a link to Dr. Ponseti’s website or mention the method by name in the text in case the parents who are researching the condition on your site do not see the wonderful testimonial that you have in today’s Daily Dose. Thanks for sharing this information with the public! You will certainly help many families and I’m confident that if they find a skilled Ponseti method doctor who does not tweak the protocol, they will have a wonderful outcome just like our family.
| September 27th, 2006 at 7:23 am
Thank you for this article on the Ponseti technique. It is truly a miracle and it works. Just like the picture, my son.s foot was completely tucked in and under, and now at 15 months has just begun to take off walking/running.
We had gone to the regionally renowned bone & joint center, but they/we were getting nowhere. Upon a traveling clinic visit by the Shriner.s Hospital from Springfield MA, Shriner.s immediately took my son in. In a few short weeks, progress was clearly evident. It seemed so simple and obvious, but apparently it wasn.t, since the first set of doctors were not getting the same results nor had they been schooled in Ponseti.
While we may someday need to do the Achilles .nick., we have not needed to thus far. I must also say, it was quite humbling to sit in the Shriner.s waiting room with my son with a little bent foot, next to children his age or older with both club feet, no feet, and other cases. We are truly blessed and cannot say enough about the great work done at Shriner.s.
| August 16th, 2007 at 3:54 am
i want to know the exact technique of ponseti cast application in ctev
| June 11th, 2009 at 4:27 pm
I also have a son that has club feet on both feet. I am truly blessed to have read and research online about the Ponsetti method. The way the article describes it, it was exactly how it happened. My son, today he is 8mos, he was also premature; however, he is standing by a couch, table, etc. Thank God for this procedure, Dr. Ponsetti, and all the doctors that practice this method.