Clubfoot Treatment Ponseti

As a Podiatrist in Anchorage, I underwent special training to apply casts to the feet to allow a non-surgical approach for kids with clubfoot here in Alaska. This mentorship was done at the University of Iowa, where Ponseti casted kids for many years. Clubfoot is one of the most common, non-life threatening, major birth defects among infants globally. Approximately one in every 1,000 newborns has clubfoot. Of those, one in three have both feet clubbed. Two out of three clubfoot babies are boys. Clubfoot is twice as likely to occur if one or both parents and/or a sibling has had it.

Clubfoot twists the heel and toes inward. It often appears like the top of the foot is on the bottom. Additionally, the clubfoot, calf, and leg are smaller and shorter than normal. When clubfoot is detected at birth, it is not painful and is correctable.

The goal of treating clubfoot is to make the infant’s clubfoot (or feet) functional, painless, and stable by the time he or she is ready to walk. Serial casting, developed by Ponseti, is the process used to slowly move the bones of a clubfoot into the proper alignment. The doctor starts by gently stretching the child’s clubfoot toward the correct position. A cast is put on to hold the foot in place. One week later, the cast is removed, the baby’s foot is stretched a little farther toward the correct position, and a new cast is applied.¬†Once the proper foot alignment is achieved, the child is fitted with special shoes or braces to keep the foot straight once corrected. These maintenance devices are used until the child is around the ago of 4.