2 October 2011
Clubfoot is one of the most common problems in pediatric orthopaedics. The threedimensional deformity is characterized with high arches, drawn up heels, pointed down toes and
a foot twisted towards the other foot. Records of clubfoot have been found in Egyptian tomb
paintings dating as early as 1000 B.C. Due to lack of understanding the functional anatomy of
the foot in the deformity clubfoot treatment is extremely controversial. The choice between
Invasive (surgical) and non-invasive treatment¹ has been debated by many specialist. However it
has only been recently, with the help of case studies and ...view middle of the document...
As the understanding of orthopedic specialist has improved, they now see that surgery
has serious consequences and declines the quality of life of the patients, “A few reports indicate
that surgery is almost invariably followed by deep scarring, which appears to be particularly
severe in infants. In addition, the average failure rate of clubfoot surgery is 25% […] many
complications can occur including wound problems, […] and loss of normal motion of the ankle
and subtalar joint³” (59-64).
However the article goes on to mention a new, non-invasive treatment called the Ponseti
method, which uses a series of manipulations and castings to correct the deformity “With
appropriate early manipulations and plaster casts, surgery of the ligaments and joints should only
be rarely necessary” (Dobbs, Morcuende, Gurnett, Ponseti, 59-64).
Morcuende’s, Dolan’s, Dietz’s and Ponseti’s Radical Reduction in the Rate of Extensive
Corrective Surgery for Clubfoot Using the Ponseti Method, summarizes a case study that was
taken in order to evaluate the efficacy of the new non-invasive method (the Ponseti method) and
the conclusion was reached that, “the Ponseti method is a very safe, efficient treatment for the
correction of clubfoot that radically decreases the need for extensive corrective surgery [… ] this
study demonstrates that with the use of the Ponseti method, ≥95% of patients’ idiopathic
clubfoot can be corrected without the need for extensive corrective surgery” (Morcuende, Dolan,
The article Treatment of Idiopathic Clubfoot: An Historical Review mentions all recorded
surgical treatments for clubfoot over the years and all the horrifying side effects that go along
with them such as scarring, and loss...