Ponseti method (Morcuende)

Radical reduction in the rate of extensive corrective surgery for clubfoot using the Ponseti method.

Morcuende JA, Dolan LA, Dietz FR, et al. Pediatrics 2004 · PMID 14754952 · doi:10.1542/peds.113.2.376

Question

Does the Ponseti method avoid the need for extensive corrective soft-tissue release surgery in idiopathic clubfoot?

Design

Single-centre cohort study at the University of Iowa reviewing consecutive infants treated with the Ponseti method.

Patients

Infants with idiopathic congenital talipes equinovarus.

Intervention

Ponseti serial manipulation and casting, percutaneous Achilles tenotomy and foot abduction bracing

Comparison

Historical rates of extensive posteromedial release surgery

Primary outcome

Need for extensive corrective surgery

Key result

Very few feet required extensive corrective surgery; relapses were strongly associated with poor adherence to foot abduction bracing.

Limitations

Single expert centre without a concurrent control group; short-to-medium follow-up.

Impact on practice

Supports the Ponseti method as first-line treatment for idiopathic clubfoot in the UK, with emphasis on brace compliance to prevent relapse.