The French functional physical therapy method for the treatment of congenital clubfoot

Abstract

The French method, also called the functional physical therapy method, is a combination of physiotherapy, splinting and surgery à la carte. The French functional physical therapy method consists of daily manipulations of the newborn’s clubfoot by a specialized physical therapist, stimulation of the muscles around the foot and temporary immobilization of the foot with elastic and nonelastic adhesive taping. Physiotherapy is optimized by early triceps surae lengthening. Sequences of plaster can also be used. If conservative treatment is no longer effective, surgery should be considered. Mini-invasive surgery is a complementary procedure to nonoperative treatment (surgery ‘à la carte’). The French method reduces but does not eliminate the need for mini-invasive surgical procedures. Equinus is the most difficult deformity to treat; posterior release is sometimes necessary in a severe foot. Very severe feet (stiff–stiff; score, 16–20) are still a challenge. However, regular manipulations and splinting improve foot morphology and stiffness, and, ultimately, make surgery easier and less extensive. From the French method to the Ponseti method, the Hybrid method or the ‘the third way’, combining the advantages of both methods, is the future. The primary reason for relapses is the inability of families to maintain the correction initially achieved. The aim of this work is to provide an overview of the French functional physical therapy method and to help understand how it has evolved over time.