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Ponseti Method

Ponseti Method

This technique involves 2 phases, a corrective phase and a maintenance phase. During the corrective phase, there is application of a series of plaster casts, followed by a minor surgical procedure known as Tenotomy. During the maintenance phase, the child will be wearing Steenbeek Foot Abduction Braces (SFABs) until they are 5 years old.

This method is simple, non-surgical and highly successful. Over 80% of children treated using this method recover without need for additional procedures.

The goals of Ponseti treatment are:

  • To have functional, pain-free feet
  • To enable a child to wear a normal shoe
  • To avoid permanent disability.

What You Need To Know!

Casting

A child with clubfoot will start off with weekly manipulation and application of plaster casts. Normally this takes 6-8 weeks.

Cast care at home

  1. Keep the cast clean and dry
  2. Do not bath your baby while in casts – lay your baby on a towel, use a soapy cloth to wash, rinse off and dry with a towel, without wetting the cast
  3. Check for cracks or breaks in the cast
  4. Rough edges at the top of the cast can be padded with some cotton wool to protect the skin from rubbing
  5. Do not put powders or lotion inside the cast
  6. Cover the cast while your child is eating and drinking
  7. Prevent small toys or objects from being put inside the cast
  8. For nappy leaks wipe the cast as clean as possible with wet wipes (do not use water or a wet cloth)
  9. You should always be able to see your baby’s toes
  10. Toes should be normal skin colour and feel warm
  11. Press the toes a few times a day to check if they are warm, and make sure that the colour comes back quickly afterwards
  12. Your baby should be able to move the toes while in the cast, both freely and when you touch them
  13. In cold weather you can put socks over the casts to keep the feet warm
  14. You can roll up a small towel and put it under the knees to support the heels when the baby is in a car seat pr carrier, or sleeping
Adapted from ACT Basic & Advanced Clubfoot Treatment Provider Courses Participant Manual page 84

Tenotomy

A tenotomy is needed in 8 out of 10 children with clubfoot.
This a small procedure which will require using local anesthetic before the last cast is applied.

Bracing

This is the last and very important stage in clubfoot treatment.

Your child will wear the brace for 23hours a day for the first 3 months.

They will then wear the brace every night time and nap time (12-14 hours a day) until they are 5 years old.

Does the brace hurt?

No, If the brace is used correctly, it will not hurt your child.

Steps to properly fit a brace

1. Put on socks

2. Lay child on their back on your lap or a flat surface

3. Fit the difficult foot in first

4. Push child’s foot down into brace until the heel is completely in the shoe

5. Check if heel of foot is down through brace inspection hole

6. Tighten the laces securely

7. Repeat process for the other foot

8. Do not straighten or bend the bar

Wearing the brace correctly is the only way to keep the foot straight. If not worn correctly, the problem will return.

Ask the Clinic Staff or the Ponseti Guide for help if you are not sure of how to put on the brace.