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Progression of idiopathic clubfoot correction using the Ponseti method

Chaudhry, Soniaa; Chu, Alicea; Labar, Amy S.a; Sala, Debra A.a; van Bosse, Harold J.P.b; Lehman, Wallace B.a

Journal of Pediatric Orthopaedics B: January 2012 - Volume 21 - Issue 1 - p 73–78
doi: 10.1097/BPB.0b013e328346c03b
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The Ponseti technique involves sequential clubfoot correction by abduction, supination, and finally dorsiflexion. Although shown to be effective, correction progression has not been examined. The Dimeglio/Bensahel classification system was used to analyze heel equinus, varus, midfoot rotation, adduction, posterior crease, medial crease, and cavus initially and after each casting. From 2000 to 2008, 123 patients (185 feet) with idiopathic clubfeet, aged below 60 days, without prior treatment were grouped by number of casts required. Successive castings achieved goals of reducing cavus and medial crease first, then gradually correcting midfoot rotation, adduction, and heel varus. Unexpectedly, heel equinus improved simultaneously with midfoot variables, as well as with final casting.

aNew York Ponseti Clubfoot Center, Pediatric Orthopaedic Surgery, Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York

bDepartment of Orthopaedic Surgery, Shriners Hospital for Children, Philadelphia, Pennsylvania, USA

Correspondence to Alice Chu, MD, Pediatric Orthopaedic Surgery, Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003, USA Tel: +1 212 598 7610; fax: +1 212 533 5345; e-mail: alice.chu@nyumc.org

This study was conducted at the New York Ponseti Clubfoot Center of NYU Hospital for Joint Diseases, New York, New York, USA

© 2012 Lippincott Williams & Wilkins, Inc.