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Clubfoot Treatment

The Treatment Phase

The treatment of clubfoot should begin as early as possible, usually within the 7-10 days of birth. Using the Ponseti Method for clubfoot treatment, a doctor gently moves the baby’s clubfoot (or feet) towards the correct position of a normal foot and then places the clubfoot in a tiny plaster cast.

With each casting, the baby’s clubfoot is gradually moved closer to the normal position, placed in a cast, the cast is removed, the foot is moved a little more, placed in a new cast and so on; this occurs every 5 to 7 days.

The Ponseti casts are long leg casts. They should be over the knee (from toe to groin) and well molded onto the foot. Casts should be removed only before a new cast is put on to guard against relapse. Plaster casts are the best material for making Ponseti casts.

In this clubfoot treatment for babies, each new cast holds the foot in a newly corrected position, allowing the bones, ligaments and tendons inside the foot to gradually re-shape. This can be done because the baby’s bones, ligaments and tendons are still not fully formed, are still soft and can be moved/shaped into the correct position.

Usually, five to six casts are required for clubfoot correction. Each time a new cast is used, the outward rotation of the foot should change by about 10-15 degrees. Very stiff feet may require 8 or 9 plaster casts. The castings usually happen over a period of two months.

Before applying the final cast, the majority of babies with clubfoot (70%) will require a small surgical procedure to lengthen their Achilles tendon. This procedure will most likely be done under local anesthesia and takes about 10 minutes for the surgeon to perform. No stitches are necessary after this minor surgery.

The last clubfoot cast, applied after this brief procedure, will be left on for two and a half to three weeks to help with healing. The last cast should be set to about 70 of external rotation. By the time the cast is removed, the tendon has usually healed to its proper length and the clubfoot repair via casts is finished.

After the castings are complete and the foot is in the normal position, the baby enters the maintenance phase, which involves wearing a brace. The brace should be started on the same day the last cast is taken off. Parents should not wait a few days to start the bracing, or the foot will relapse back to its clubfoot position.

The Ponseti Method is painless, fast, cost-effective and successful in almost 100% of all clubfoot cases in which the clubfoot is discovered at birth. The Ponseti method is endorsed and supported by World Health Organization, National Institutes of Health, American Academy of Orthopedic Surgeons, Pediatric Orthopedic Society of North America, European Pediatric Orthopedic Society and many more.

» Clubfoot Treatment Overview
» Clubfoot Treatment Phase I
» Clubfoot Treatment Phase II
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