The Treatment and Management of Clubfoot
Should a newborn develop idiopathic or syndromic talipes equinovarus, what can be the mode of treatment?
According to the American Academy of Pediatrics, the Ponseti Method can help. This treatment, which was developed by Ignatio Ponseti, involves three phases:
This involves casting the affected foot within 1 to 3 weeks after birth. The cast is replaced weekly until all elements of the deformity are corrected (except for tight Achilles tendon). In many cases, 7 weeks is enough to complete Phase 1. Please note that only a certified pediatric orthopedic surgeon who knows the Ponseti Method well should do the casting.
It involves a minor surgery, called Achilles tenotomy, to correct the rigid Achilles tendon. This can be done in the doctor’s clinic under local anesthesia. Achilles tenotomy, which makes a small incision in the tendon to allow the affected foot to flex upwards, is often required in 90% of cases. After the surgery, the baby needs to wear a final cast for about 3 weeks.
This involves long-term full-time bracing for 3 months after removing the final cast. After full-time bracing, the baby only needs to wear the brace every night until they turn 4 or 5.
Note that despite the Achilles tenotomy, the American Academy of Orthopedic Surgeons considers the Ponseti Method a nonsurgical way to treat clubfoot in a newborn. Should the deformity persist or come back, they may recommend more extensive surgical procedures.