The Ponseti Method

Dr. PonsettiThe Ponseti Method was developed by Dr. Ponseti over 50 years ago at the University of Iowa. It has been extremely well documented and is now considered the gold standard treatment in most developed countries.

Starting at 1-2 weeks of age, the tendons and ligaments in the foot are gently manipulated. This does not hurt the child. The foot is then casted for 5-7 days. This procedure is repeated over a 6-8 week period. In 85% of cases, the child will then need a tenotomy to release the heel down. This procedure, usually done using local anaethisia, requires no stitches and takes about 10 minutes. The final cast after the tenotomy is kept on for 3 weeks. At this point the position of the feet are completely corrected.

The child will then wear a foot abduction brace, initially 23 hours a day for 3 months and then only at night and during naps for 5 years. The brace prevents the corrected feet from relapsing and is a critical phase of successful treatment. The brace consists of a bar with simple strap-on shoes, that hold the feet in a dorsiflexed position about a shoulder width apart.

After 5 years, the child should be left with supple, pain-free feet that look and function completely normally. In cases where only one foot is affected the corrected foot may be a different size than the other foot.

Treatment is successful in 95% of cases restoring normal appearance and full functionality of the feet.