Ponseti Method versus surgical treatment in a teenage girl with neglected clubfoot: a case report

Abstract

Introduction: Congenital clubfoot is the most common foot deformity. It affects 1 - 7/1000 live births. Clubfoot is considered neglected when it has not been treated before the child walks. The treatment of choice in these patients is usually the correction of the deformity with external fixation. However, this treatment is not exempt from complications and does not restore the anatomy. Case: Sixteen years-old female with neglected bilateral clubfoot underwent extended posterior internal release and gradual correction with an external fixator on her right foot. Due to the poor results and tolerance to the surgical treatment of the right foot, she underwent the Ponseti Method on her left foot. Gait analysis was performed six months after the treatment was completed. The joint relations were closer to normal in the limb treated with the Ponseti method, and the gait pattern was similar in both feet. Conclusion: The Ponseti method is a treatment option for neglected clubfoot even in skeletally mature patients. This technique has not only been shown to restore foot anatomy and reduce the risk of overcorrection. It is also better tolerated by the patient and brings lower costs to the health insurance system.

Keywords

• Neglected clubfoot
• treatment outcome
• tibialis anterior tendon transfer
• external fixation
• outcomes comparison
• serial casting