Clubfoot is a common condition that results in multiple deformities of the foot. There is typically a higher-than-normal arch and a turning in of the foot. It can occur in one or both feet. Clubfoot may be detected on a prenatal ultrasound or diagnosed at birth. It is not a painful condition but can lead to pain and difficulties walking later in life if left untreated.
Ponseti Method
Clubfoot treatment is performed using the Ponseti casting method. This involves a series of weekly visits with gentle stretching and casting for about 4 to 6 weeks. The foot will gradually move to a turned out position. The casts extend from the toes and over the knee to the thigh.
Toward the end of the casting process a small procedure, called Achilles tenotomy, is performed in the clinic or the operating room to bring the foot to its final corrected position. This involves cutting the entire tendon. Because of the child’s young age, the tendon reliably grows back into a full-strength tendon. The final cast is left on for about 3 weeks.
Bracing Stage:
Once the final cast is removed, the child is placed into special Ponseti shoes and bar. If the shoes are not worn exactly as instructed, the clubfoot will relapse 80% of the time and treatment will have to start over.
- First, the shoes will be worn full time for 3 months. The shoes may be removed for diaper changes, bath-time, and stretching.
- After that, the shoes are worn at nighttime and during naps until about the age of 4.
- About 25% of children with clubfeet will need a surgery at an older age, commonly preschool age.
