Approach To A Clubfoot Deformity Patient: Ponseti Management

  • Ajmera A Department of Orthopaedics, Mahatma Gandhi Memorial Medical College, Indore (M.P.)
  • Dr Saurabh Jain Department of Orthopaedics, Mahatma Gandhi Memorial Medical College, Indore (M.P.)
Keywords: Club foot, Ponseti method, Manipulation and Casting

Abstract

Clubfoot is among the most common congenital foot deformities, needing correction, which when left untreated can cause severe cosmetic, functional and social issues. Ponseti method has revolutionized the treatment in favour of nonsurgical serial manipulation and casting. Simultaneous correction of cavus, adductus, and varus followed by correction of equinus by percutaneous tenotomy can be achieved in mean 5 weeks. It is based on sound understanding of the functional anatomy of foot (synchronous movements of the tarsal bones at subtalar joint to unlock the deformity) and biological response of young connective tissue and bone to change in direction of mechanical stimuli which can gradually reduce or almost eliminate deformities of clubfeet. This review article describes, approach to a clubfoot patient, its features, classification, assessment, ponseti method of manipulation and casting and errors of treatment and their management. Aim of this review article is to compile the important information pertaining to clubfoot management which will be useful for the basic orthopaedic surgeon in their clinical practice and for post-graduate students.

Downloads

Download data is not yet available.

References

1. Kelly DM. Congential anomalies of lower extremity. In: Canale ST, Beaty JH, editors. Campbell’s operative orthop. 12th ed. St. Louis: Mosby Elsevier; 2008. pp. 1078–100.
2. Ponseti IV, Smoley EN. Congenital Clubfoot: The Results of Treatment. J Bone Joint Surg. 1963. 45A(2):2261–70.
3. Ajmera A, Jain S, Singh A, Solanki M, Verma A. Simultaneous lateral column shortening along with differential distraction by JESS for rigid neglected club foot correction. J Paediatr Orthop (Br). 2019;28:579-85.
4. Pirani S. Naddumba E. In: Staheli’s Ponseti club foot management. Teaching manual for healthcare providers. 2008;1:1-48.
5. Kite JH. Non-operative treatment of congenital clubfoot. Clin Orthop Relat Res 1972; 84:29–38.
6. Morcuende JA, Dolan LA, Dietz FR, Ponseti IV. Radical reduction in the rate of extensive corrective surgery for clubfoot using the Ponseti method. Pediatrics. 2004;113(2):376-80.
7. Dobbs MB, Nunley R, Schoenecker PL. Long-term follow-up of patients with clubfeet treated with extensive soft-tissue release. J Bone Joint Surg Am. 2006;88(5):986-96.
8. Herzenberg JE, Radler C, Bor N. Ponseti versus traditional methods of casting for idiopathic clubfoot. J Pediatr Orthop 2002; 22:517–21.
9. Ippolito E, Farsetti P, Caterini R, Tudisco C. Long-term comparative results in patients with congenital clubfoot treated with two different protocols. J Bone Joint Surg Am. 2003;85(7):1286-94.
10. Dobbs MB, Rudzki JR, Purcell DB, Walton T, Porter KR, Gurnett CA. Factors predictive of outcome after use of the Ponseti method for the treatment of idiopathic clubfeet. J Bone Joint Surg Am. 2004;86(1):22-7.
11. Cooper DM, Dietz FR. Treatment of idiopathic clubfoot. A thirty-year follow-up note. J Bone Joint Surg Am. 1995;77(10):1477-89.
12. Ionasescu V, Maynard JA, Ponseti IV, Zellweger H. The role of collagen in the pathogenesis of idiopathic clubfoot. Biochemical and electron microscopic correlations. Helv Paediatr Acta. 1974;29(4):305-14.
13. Ponseti IV, Campos J. Observations on pathogenesis and treatment of congenital clubfoot. Clin Orthop 1972; 84:50–60.
14. Ippolito E, Ponseti IV. Congenital club foot in the human fetus. A histological study. J Bone Joint Surg Am. 1980;62(1):8-22.
15. Brand RA, Laaveg SJ, Crowninshield RD, Ponseti IV. The center of pressure path in treated clubfeet. Clin Orthop Relat Res. 1981;(160):43-47.
16. Ponseti IV, El-Khoury GY, Ippolito E, Weinstein SL. A radiographic study of skeletal deformities in treated clubfeet. Clin Orthop Relat Res. 1981;(160):30-42.
17. Ponseti IV. Treatment of congenital club foot. J Bone Joint Surg Am. 1992;74(3):448-454.
18. Ponseti IV. The treatment of congenital clubfoot. J Orthop Sports Phys Ther. 1994;20(1):1
19. Laaveg SJ, Ponseti IV. Long-term results of treatment of congenital club foot. J Bone Joint Surg Am. 1980;62(1):23-31.
20. Pirani S, Outerbridge HK, Sawatzky B, Stothers K. A reliable method of clinically evaluating a virgin clubfoot evaluation. 21st World Congress of SICOT. 18–23 April 1999; Sydney, Australia.
21. Ponseti IV. Clubfoot management. J Pediatr Orthop. 2000;20(6):699-700.
22. Ponseti IV. Correction of the talar neck angle in congenital clubfoot with sequential manipulation and casting. Iowa Orthop J. 1998;18:74-5.
23. Morcuende JA, Abbasi D, Dolan LA, Ponseti IV. Results of an accelerated Ponseti protocol for clubfoot. J Pediatr Orthop. 2005;25(5):623-6.
24. Ponseti IV. Common errors in the treatment of congenital clubfoot. Int Orthop. 1997;21(2):137-41
25. Ponseti IV. Treatment of the Complex Idiopathic Clubfoot, Clin Orth Rel Res 2006;451:171.
Published
2020-12-16
How to Cite
1.
Ajmera A, Jain S. Approach To A Clubfoot Deformity Patient: Ponseti Management. ojmpc [Internet]. 2020Dec.16 [cited 2021Jan.21];26(2):52-4. Available from: https://ojmpc.com/index.php/ojmpc/article/view/119
Section
Review Article