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Foot size asymmetry following Ponseti treatment versus comprehensive surgical releases for unilateral clubfeet

Wallace, Juanita J.a; White, Hank D.a; Augsburger, Samuel F.a; Talwalkar, Vishwas R.a,b; Muchow, Ryan D.a,b; Iwinski, Henry J.a,b; Walker, Janet L.a,b

Journal of Pediatric Orthopaedics B: March 2019 - Volume 28 - Issue 2 - p 153–158
doi: 10.1097/BPB.0000000000000548

Using age and height matched cohorts with unilateral idiopathic clubfeet (n=40 each), we retrospectively reviewed pedobarographic studies to determine the impact of treatment, Ponseti versus comprehensive surgical releases (CSR), on the foot length, width, and contact area. The foot pressures were determined by self-selected walking across a force plate. Ponseti treatment results in more symmetrical foot lengths, widths, and total contact areas with an improvement of 1.3 shoe sizes difference compared with treatment with CSR. This suggests that there is improved growth in the clubfoot in those treated with Ponseti management compared with those treated with CSR.

aShriners Hospitals for Children Medical Center

bDepartment of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, Kentucky, USA

Correspondence to Janet L. Walker, MD, Shriners Hospitals for Children Medical Center, Lexington, KY 40508, USA Tel: +1 859 266 2101; fax: +1 859 268 5762; e-mail:

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