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A Modified Ponseti Method for the Treatment of Idiopathic Clubfoot: A Preliminary Report

Xu, Rui Jiang MD

Journal of Pediatric Orthopaedics: April/May 2011 - Volume 31 - Issue 3 - p 317–319
doi: 10.1097/BPO.0b013e31820f7358

Background The regular Ponseti method for the treatment of idiopathic clubfoot requires a series of manipulations and castings at weekly intervals. It is not known whether the correction could be achieved in a shorter period of time with multiple manipulations and castings per week. This study was designed to evaluate the outcome of a modified treatment program with manipulation and casting offered twice a week.

Methods The study included the modified group (26 patients with 40 idiopathic clubfeet treated with the Ponseti method twice a week) and the regular group (20 patients with 32 idiopathic clubfeet treated once a week). The average age of the patients at the time of treatment was 63.05 days in the regular group and 92.7 days in the modified group.

Results All aspects of the deformity with the exception of the equinus were corrected in 20.61 days in the modified group and in 35.35 days in the regular group (P=0.0001). There were no differences between the 2 groups in the average number of casts (P=0.61). Percutaneous Achilles tenotomy was performed in 87.5% (35 of 40) of those in the modified group and 87.5% (28 of 32) of those in the regular group (P=0.47). A corrective surgery for a complete correction of the deformity was performed in 4 feet in the modified group (10%; 2 posteromedial releases; 2 posterior releases) and 3 feet in the regular group (10%; 2 posteromedial releases; 1 posterior release).

Conclusions The modified Ponseti method with the treatment program twice a week is safe and effective. It significantly shortens the timeframe for the treatment.

Level of Evidence The study of therapeutic studies investigating the results of the treatment is level II.

Department of Pediatric Orthopaedic Surgery, Chinese PLA General Hospital, Beijing, China

None of the authors received financial support for this study.

Reprints: Rui Jiang Xu, MD, Department of Pediatric Orthopaedic Surgery, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, People's Republic of China. e-mail:

Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.