Ponseti Method for clubfoot

NewsBot · Jul 18, 2026

A Modified Ponseti Method for Skeletally Mature Complex Foot Deformities
Brandon Zaldivar et al
Foot Ankle Int. 2026 Jul 16:10711007261456735.

Background: Managing skeletally mature complex foot deformities (CFDs) remains challenging, and the effectiveness of the Ponseti method (PM) beyond childhood is not established. This study assesses improvements in foot deformity among adolescent and adult patients with idiopathic and acquired CFD treated with serial casting as a presurgical correction strategy.

Methods: A retrospective cohort study encompassing 58 skeletally mature patients (78 feet) with idiopathic or acquired CFD treated with a modified PM between 2020 and 2024 was conducted. Patients were categorized by etiology, and deformity severity in cavus, varus, adductus, and equinus was documented at baseline, after casting, and postoperatively. Analysis of variance and Tukey honestly significant difference test assessed changes over time. Postoperative and casting complications, relapses, and Foot and Ankle Outcome Score (FAOS) were reported at final follow-up.

Results: Twenty-eight patients with idiopathic CFD and 30 with acquired CFD were studied. After casting, 95% (55/58) required additional procedures. A plantigrade foot was achieved in 89% (69/78). Seventy-seven percent (60/78) of feet required procedures in addition to Achilles tenotomy. Improvements across all deformity planes were attributable to serial casting (P < .001), and postoperatively, equinus improved significantly (P < .04 and P < .01) in both groups. Casting-related injuries needing wound care occurred in 8.9% (7/78). After a median follow-up of 17 months, 13% (10/78) experienced relapse. Postoperative complications included 1 wound dehiscence and 1 case of stiffness. The median FAOS for idiopathic and acquired groups were 87 and 85, respectively.

Conclusion: A modification of the PM, using serial leg casting as a preoperative correction strategy for idiopathic and acquired CFD was associated with reduced need for, or reduced complexity of, major reconstructive foot surgery, with high rates of plantigrade feet and low rates of arthrodesis. This approach could redefine treatment paradigms in resource-constrained settings and for multiplanar correction of foot deformity.
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NewsBot · Aug 2, 2026 at 9:29 PM

Midterm outcomes of complex clubfoot treated with the modified Ponseti method: A comparative study of primary and referred cases
Mehmet Ali Dolap , Ahmet Yiğit Kaptan, Turan Bal, Baki Volkan Çetin, Celal Bozkurt, Muhammed Işıkyıldız, Mehmet Akif Altay
Jt Dis Relat Surg. 2026 Jul 24;37(3):873-881.

Objectives: This study aims to evaluate the midterm clinical outcomes of patients with complex clubfoot treated using the Ponseti method and to assess the sustainability of deformity correction over time.

Patients and methods: Between January 2016 and January 2021, a total of 38 feet in 26 patients with complex clubfoot treated using the modified Ponseti method were retrospectively analyzed. The patients were divided into two groups: those treated entirely in our institution (study center group) and those referred from external centers after unsuccessful initial treatment (external center group). Clinical severity was assessed using the Pirani score, and ankle dorsiflexion (DF) was measured during follow-up. Functional outcomes were evaluated using the Pirani-Based Score (PBS) and the Oxford Ankle Foot Questionnaire (OxAFQ). Relapse rates, additional procedures, and treatment success were analyzed. Independent predictors of outcomes were identified.

Results: Of a total of 26 patients included in the study, 2 were male and 24 were female with a mean age of 6.78 ± 1.29 (range, 5 to 8) years. Of these patients, 14 (53.8%) had unilateral involvement, while 12 (46.2%) had bilateral deformity. The external clinic group presented at a significantly later age than the study center group (p < 0.001), while baseline deformity severity was comparable. Pirani scores and DF measurements improved significantly in both groups, with no intergroup differences during follow-up (p > 0.05). Functional outcomes showed a significant difference in PBS scores, which were higher in the external clinic group (p = 0.045), indicating worse functional performance, while the OxAFQ scores were similar between groups (p = 0.911). Relapse rates were higher in the own clinic group but did not reach statistical significance (p = 0.254). Multivariate analysis revealed that age was the only independent predictor of treatment success (odds ratio [OR] = 2.067, p = 0.019), while referral status was not an independent determinant.

Conclusion: The modified Ponseti method provides effective midterm correction in complex clubfoot regardless of referral status. Although referred patients present later and may demonstrate worse functional outcomes, referral source does not independently influence treatment success. Early recognition and appropriate application of modified Ponseti principles remain critical for optimal outcomes.
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NewsBot · Aug 3, 2026 at 10:16 PM

Cast Removal by Soaking Reduces Infant and Parental Anxiety Without Affecting Clinical Outcomes in Ponseti-Treated Idiopathic Clubfoot: A Prospective Controlled Trial
Tayfun Bacaksiz et al
Children 2026, 13(8), 1007; https://doi.org/10.3390/children13081007

Highlights
What are the main findings?

•
Home-based cast removal by soaking was associated with clinical outcomes comparable to oscillating saw removal in infants treated with the Ponseti method. Second bullet.
•
The soaking technique was associated with lower infant distress, reduced parental anxiety, and fewer cast-removal–related complications.

What are the implications of the main finding?

•
Home cast removal by soaking may be considered a family-centered alternative to clinic-based oscillating saw removal for appropriately selected infants with idiopathic clubfoot.
•
With standardized parental education, the soaking technique may improve the treatment experience without compromising treatment effectiveness.

Abstract
Background: Cast removal is an essential but often stressful component of the Ponseti method for idiopathic clubfoot. The impact of different cast removal techniques on infant stress, parental anxiety, and treatment outcomes remains insufficiently explored. Methods: This prospective, quasi-randomized controlled trial included 84 infants with unilateral idiopathic clubfoot treated using the Ponseti method. Patients were allocated to cast removal by oscillating saw in the outpatient clinic (Group 1, n = 42) or by soaking and peeling at home prior to clinic visits (Group 2, n = 42). The primary outcome was the number of casts required to achieve correction and readiness for percutaneous Achilles tenotomy. Secondary outcomes included infant crying time, maximum heart rate during cast removal, parental anxiety assessed using the Short State Anxiety Inventory Scale (SAIS), cast removal time, hospital stay duration, and cast-removal–related complications. Results: There was no significant difference between groups regarding pre- or post-treatment Pirani and Dimeglio scores or the number of casts required (p > 0.05). Infant crying time, heart rate during cast removal, and parental anxiety scores were significantly higher in the oscillating saw group (p < 0.001). Cast-removal–related complications were more frequent in the oscillating saw group (p = 0.003). Conclusions: In this study, home-based soaking and peeling provided clinical outcomes comparable to oscillating saw removal and was associated with lower infant distress markers, lower parental anxiety scores, and fewer observed cast-removal–related complications. These findings suggest that soaking and peeling may represent a family-centered alternative for selected families receiving appropriate instruction.
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Ponseti Method for clubfoot

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Ponseti Method for clubfoot

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

"New" stretching method for plantar fasciitis.

Measurement methods for forefoot varus

Dr. Nicholas Romanov's Pose Method of Running

Looking for Forensic Podiatry: Principles and Methods, Second Edition

LQDCELL Method from Puma

Surgery Versus Nonsurgical Methods in Treating Neuropathic Plantar Forefoot Ulcers

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Share This Page

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