Clubfoot is a relatively common foot abnormality that affects around 1 in 1,000 children in the United States. If a doctor diagnoses the condition at birth, he or she may recommend the Ponseti method as a form of treatment. Find out what the Ponseti method involves, and learn more about the steps a specialist may need to take to help your child recover fully from the condition.
Causes of clubfoot
Clubfoot occurs when a child's foot points down and in. The condition is twice as common in boys than girls, and around 50 percent of affected children have the problem with both feet. The condition occurs because the tendons are too short and tight.
Doctors generally advise parents that the condition is idiopathic, which means there is no known cause behind the deformity. Some families have a higher genetic risk of the issue, and children with other conditions are also more likely to get clubfoot. For example, kids with hip dysplasia or spina bifida may also get this problem.
Non-surgical stage
The Ponseti method is the main treatment option that doctors recommend. Your doctor will probably recommend that your child receives treatment via the Ponseti method within two weeks of birth, as this increases the likelihood of a successful outcome.
To start with, a specialist will carefully manipulate the affected foot or feet by hand and try to slowly alter the bend. Once the specialist believes that he or she has addressed the abnormality, he or she will fit a special cast that holds the leg and foot in place. The specialist will then repeat the process weekly, removing the cast, stretching and repositioning the foot, before putting the cast back in place.
This process generally lasts for up to eight weeks. If the clubfoot is relatively minor, this stage of the Ponseti method is sometimes sufficient, but a lot of children also need some form or surgery to fully correct the problem.
Surgical stage
After the manipulation and casting method, a specialist will assess the deformity. Many babies then need a minor procedure called an Achilles tenotomy to fully correct the clubfoot. A doctor will use a special instrument to cut the child's tendon, after which he or she will then fit a new cast to protect the tendon while it heals.
The cut is so small that the child will not need stitches. What's more, the tendon normally heals within around three weeks, after which the regrown tendon is the right length. This normally fixes the issue, but the child must then also wear braces to make sure the repair is permanent.
Wearing braces
Unfortunately, clubfoot has a tendency to come back, so children must also wear braces (sometimes known as boots and bar) for several years. These orthopedic devices help the foot stay in place and allow the tendon to develop normally as the child grows.
Your child will probably wear the braces for most of the day. Over time, as the child develops, he or she may only need to wear the device overnight, but the boots and bar will probably remain in place for up to four years.
Babies normally find it hard to adjust to this device to start with, but children quickly grow accustomed to this new regime. Parents must remain committed to this process, as the problem can easily recur if you take the brace off for too long.
Success rates
Clubfoot affects around 150,000 children every year, mostly in developing nations. The Ponseti method is successful in nearly 100 percent of cases. The method offers parents a painless and effective way to permanently fix the problem, although some people admit that the boots and bar stage is inconvenient.
While doctors strongly recommend the Ponseti method for newborns, older children may also benefit. For example, children who have undergone failed surgery can still respond to this type of treatment. The oldest child recorded underwent the treatment at the age of 10.
Most doctors now recommend the Ponseti method as an effective way to treat clubfoot. Talk to your doctor or orthopedic specialist from a clinic like Town Center Orthopaedic Associates for more information.
