Radical reduction in the rate of extensive corrective surgery for clubfoot using the Ponseti method

Jose A Morcuende; Lori A Dolan; Frederick R Dietz; Ignacio V Ponseti

doi:10.1542/peds.113.2.376

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Radical reduction in the rate of extensive corrective surgery for clubfoot using the Ponseti method

Journal article

Peer reviewed

Radical reduction in the rate of extensive corrective surgery for clubfoot using the Ponseti method

Jose A Morcuende, Lori A Dolan, Frederick R Dietz and Ignacio V Ponseti

Pediatrics (Evanston), Vol.113(2), pp.376-380

02/2004

DOI: 10.1542/peds.113.2.376

PMID: 14754952

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Abstract

The purpose of this study was to evaluate the efficacy of the Ponseti method in reducing extensive corrective surgery rates for congenital idiopathic clubfoot. Consecutive case series were conducted from January 1991 through December 2001. A total of 157 patients (256 clubfeet) were evaluated. All patients were treated by serial manipulation and casting as described by Ponseti. Main outcome measures included initial correction of the deformity, extensive corrective surgery rate, and relapses. Clubfoot correction was obtained in all but 3 patients (98%). Ninety percent of patients required </=5 casts for correction. Average time for full correction of the deformity was 20 days (range: 14-24 days). Only 4 (2.5%) patients required extensive corrective surgery. There were 17 (11%) relapses. Relapses were unrelated to age at presentation, previous unsuccessful treatment, or severity of the deformity (as measured by the number of Ponseti casts needed for correction). Relapses were related to noncompliance with the foot-abduction brace. Four patients (2.5%) underwent an anterior tibial tendon transfer to prevent further relapses. The Ponseti method is a safe and effective treatment for congenital idiopathic clubfoot and radically decreases the need for extensive corrective surgery. This technique can be used in children up to 2 years of age even after previous unsuccessful nonsurgical treatment.

Follow-Up Studies

Humans

Child, Preschool

Infant

Male

Treatment Outcome

Combined Modality Therapy

Manipulation, Orthopedic - methods

Braces

Female

Clubfoot - surgery

Retrospective Studies

Clubfoot - therapy

Orthopedic Procedures - statistics & numerical data

Child

Casts, Surgical

Details

Title: Subtitle: Radical reduction in the rate of extensive corrective surgery for clubfoot using the Ponseti method
Creators: Jose A Morcuende - Department of Orthopaedic Surgery, University of Iowa, Iowa City, Iowa, USA. jose-morcuende@uiowa.edu
Lori A Dolan
Frederick R Dietz
Ignacio V Ponseti
Resource Type: Journal article
Publication Details: Pediatrics (Evanston), Vol.113(2), pp.376-380
DOI: 10.1542/peds.113.2.376
PMID: 14754952
NLM abbreviation: Pediatrics
ISSN: 0031-4005
eISSN: 1098-4275
Publisher: American Academy of Pediatrics; United States
Language: English
Date published: 02/2004
Academic Unit: Stead Family Department of Pediatrics; Orthopedics and Rehabilitation
Record Identifier: 9984040312002771

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