[Treatment of congenital clubfoot with the Ponseti method].
OBJECTIVE
The primary therapy for congenital clubfoot is non-surgical involving manipulation and serial casting. With traditional casting, relatively large numbers of feet require extensive surgery to achieve full correction. The purpose of this study was to evaluate the efficacy of the Ponseti method.


METHODS
Between 1.1.2004 und 31.12.2005, 29 patients with 41 clubfeet were treated with the Ponseti method. Only patients without any prior treatment were included. Classification followed Pirani's score. The number of casts to full correction, tenotomies, number of posteromedial releases, dorsi-, plantarflexion and hindfoot position were documented. The follow-up time was 1-9 months, the average follow-up time was 9.1 months.


RESULTS
39 clubfeet were successfully treated with the Ponseti method. The average Pirani score was 4.9. Percutaneous tenotomies were necessary in 34 of the clubfeet. Average dorsiflexion was 19 degrees and plantarflexion 42 degrees . After failed Ponseti treatment 2 feet were treated with a posteromedial release.


CONCLUSIONS
With the Ponseti method the need for extensive corrective surgery is greatly reduced. We recommend the Ponseti method as standard therapy in clubfoot management.
Eberhardt
O
O
Klinikum Stuttgart Olgahospital, Orthopädische Klinik, Stuttgart. o.eberhardt@olgahospital.de
Schelling
K
K
Parsch
K
K
Wirth
T
T
D002370:Casts, Surgical; D003025:Clubfoot / Q000175:diagnosis* / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007103:Immobilization / Q000379:methods*; D008297:Male; D026201:Musculoskeletal Manipulations / Q000379:methods*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D016896:Treatment Outcome