Additional recommended knowledge
The Ponseti Method
A manipulative technique that corrects congenital clubfoot without invasive surgery. Developed by Dr Ignacio V. Ponseti of the University of Iowa, USA in the 1950's"
Description of The Ponseti Method
"The manipulative treatment of clubfoot deformity is based on the inherent properties of the connective tissue, cartilage, and bone, which respond to the proper mechanical stimuli created by the gradual reduction of the deformity. The ligaments, joint capsules, and tendons are stretched under gentle manipulations. A plaster cast is applied after each manipulation to retain the degree of correction and soften the ligaments. The displaced bones are thus gradually brought into the correct alignment with their joint surfaces progressively remodeled yet maintaining congruency. After two months of manipulation and casting the foot appears slightly overcorrected After a few weeks in splints however, the foot looks normal.
Proper foot manipulations require a thorough understanding of the anatomy and kinematics of the normal foot and of the deviations of the tarsal bones in the clubfoot. Poorly conducted manipulations will further complicate the clubfoot deformity. The non-operative treatment will succeed better if it is started a few days or weeks after birth and if the orthopaedist understands the nature of the deformity and possesses manipulative skill and expertise in plaster-cast applications."
Reference: UI Healthcare[1]
Clubfoot (Talipes) affects almost 150,000 children annually. Almost 80% of these children live in developing nations. Dr Ponseti's technique is painless, fast, cost-effective and successful in almost 100% of all congenital clubfoot cases. The Ponseti method is endorsed and supported by World Health Organisation [2], National Institutes of Health[3], American Academy of Orthopedic Surgeons [4], Pediatric Orthopaedic Society of North America [5], European Paediatric Orthopaedic Society [6], CURE [7], STEPS Charity UK [8], STEPS Charity South Africa [9], and A Leg to Stand On (India) [10] and others .
At the 2007 International Clubfoot Symposium attended by 200 doctors from 44 countries, papers were presented for an estimated 10,000 children successfully treated with the technique around the world in the past few years.
The Ponseti International Association for the Advancement of Clubfoot Treatment was founded in 2006. The Ponseti International Association aims to improve the treatment of children born with clubfoot through education, research and improved access to care.
References
1. Congenital clubfoot. Fundamentals of Treatment (Oxford University Press), 1996. Available through Dept. of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242. E-mail ignacio-ponseti@uiowa.edu.
2. Clubfoot: Ponseti Management. Global-HELP Publications. http://www.global-help.org
3. University of Iowa Healthcare[11]
4. University of Iowa Carver College of Medicine [12]
Ponseti doctors worldwide
1. US Doctor websites [13]
2. Worldwide physicians [14]
3. Patient / Parent reviews [15]
4. Ponseti doctors in South Africa [16]
Links
1. University of Iowa website clubfoot page http://www.uihealthcare.com/topics/medicaldepartments/orthopaedics/clubfeet/index.html
2. Ponseti Links (a comprehensive list of links to information about Ponseti [17]
3. Ponseti Method information and support group [18]
4. Other Support Groups and family websites [19]
5. Valuable information on clubfoot for parents - South African website [20]
6. UK Support and information for parents - UK website [21]
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