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news News Thursday, March 7, 2019 Thursday, March 7, 2019 11:49 AM - Thursday, March 7, 2019 11:49 AM

Non-surgical treatment for clubfoot

Non-surgical treatment for clubfoot

Clubfoot is a congenital condition that occurs in about one of every 1,000 births. The foot is twisted inward or downward. It can happen in one or both feet and can be mild or severe. Diagnosis occurs via ultrasound in utero or at the time of birth.

Peter Smith, M.D., a pediatric orthopaedic surgeon at Shriners Hospitals for Children — Chicago, explains further. “Clubfoot is a congenital condition. Children are born with this. About 50 percent of the time both feet are involved," he shares. “Although it is not preventable, it is highly treatable.”

Correction through casting: The Ponseti method

In the past, surgical treatment was advised to treat the foot. However, a technique called the Ponseti method allows for non-surgical correction of the condition. The foot is stretched weekly and placed in a new cast every time. A brace is then used to hold the foot in the corrected position.

While treatment may sound painful, Dr. Smith clarifies it’s a gentle manipulation. The foot is moved into a position of the greatest correction that is achievable that week.

A complete evaluation of the child prior to treatment identifies any associated conditions, such as deformities of the knees, hips or upper extremities. The whole child is treated for optimal success.

Care during correction

Treatment requires families to bring their child in weekly while undergoing the casting. After casting is complete, a brace is needed to hold the feet apart at night to maintain the correction. The Ponseti method is more effective long-term than extensive surgical treatment. “All of this is well worth it, so that by the time the children are walking, their feet are flat on the ground,” said Dr. Smith. “They’re wearing regular shoes."

Life after casting

Gait analysis at the Chicago Shriners Hospital motion analysis center has shown that adults treated with the Ponseti method realized better outcomes. They experienced less pain and could participate in more activities than those whose childhood clubfoot was treated with surgery.

The goal of treatment is a child who can fully participate in the same activities as other kids, growing into adults with ideal function.

“We know that this is one of the most common musculoskeletal conditions. A relatively simple treatment with casting can result in relatively normal looking feet that function well," Dr. Smith said. As part of Shriners Hospitals' mission to share our medical expertise, the Chicago Shriners Hospital's motion analysis center physicians and clinicians have traveled to other countries to help more children receive Ponseti method care for clubfoot. "We've done teaching on this method to doctors and therapists in other countries. Our hope is that this treatment will be adopted all over the world. There are many people working on spreading awareness; among them, many of the Shriners Hospitals doctors."

To make an appointment at the Chicago Shriners Hospital for a child with clubfoot or club feet, please call 773-385-KIDS (5437).

Listen to an interview with Dr. Peter Smith, a pediatric orthopaedic surgeon at Shriners Hospitals for Children — Chicago.

Patient wearing casts, smiling