The Ponseti method has become the standard of care for newborns with clubfoot, but is your doctor really doing the Ponseti method? Many claim to use the Ponseti method, but at a recent meeting in Washington, DC for the Bone and Joint Decade Meeting International Clubfoot Symposium this problem was discussed in detail. There are a few tips that you as a parent can use to evaluate your child’s care.
1. Casting should be above the knee
2. Plaster material should be used – sometimes on older children fiberglass may be used to reinforce the plaster
3. The cast should be changed every 5-7 days
4. Cast should not be removed right before application of a new cast
5. The first cast will look almost worse as the front part of the foot and the back part of the foot have to be put on the same plane – This is called the “Magic Move”
6. Achilles tendon release in done in 85% of the cases – This is a minimally invasive procedure
7. The last cast should be left on for 3 weeks and bracing should be ordered during this time
8. Recurrence rates without bracing is 80%, but with bracing is 6%
9. Do not stop bracing until advised by your doctor
10. A study from the University of Iowa had a mean bracing time of 49.5 months
11. Ponseti International Website provides a list of recommended providers – use this list, do not just rely on a referral
12. The doctor treating your child should be putting on the cast, not a technician
On a final note, Dr. Ponseti recently passed away but his legacy will continue on. I had the honor of learning this treatment from him directly and it was an amazing experience. There are very few real heroes in the world, Dr. Ponseti was a true hero. He was a man of vision, compassion, bravery and perseverance.
By Dr. Patrick A. DeHeer, DPM