Ponseti Method

About Dr. Ponseti

Ignacio Ponseti was born in 1914 on the Spanish Island of Menorca. He attended the University of Barcelona where he earned a degree in biology as well as an MD. Following graduation in 1936, Ponseti served as a medic during the Spanish Civil War, treating hundreds of orthopaedic wounds.

In 1941, Dr. Ponseti came to the Unversity of Iowa to finish his residency and went on to join the faculty of orthopaedic medicine in 1944. Dr. Arthur Steindler, the head of the department at the time, asked Ponseti to review the results of clubfoot surgeries being performed at the University of Iowa, and what he learned was not encouraging. He found that, in adulthood, former surgical patients often experienced foot stiffness, pain, arthritis, and limited mobility, and in many cases required additional surgery.

By studying the anatomy and functions of a baby’s foot, Dr. Ponseti developed a non-surgical method to correct clubfoot in infants through gentle manipulation of the feet followed by the application of plaster casts. The success of the “Ponseti Method” has been well documented through patient studies and research articles.

Dr Ponseti died in 2009 at the age of 95.

The Ponseti Method

The method is simple. It requires only skill, patience and plaster. Taking a baby’s foot in his gentle, age-spotted hands, Ponseti stretches the medial ligaments slightly and holds the foot in place while an assistant applies a cast using the same technique the doctor employed to treat the wounded in the fight against Gen. Ferdinand Franco’s fascists.

After a week, the first cast is cut away. The ligaments are stretched further, and a second cast goes on. Another week, another cast. The cycle typically continues for about four weeks. Then, in most cases, comes a procedure called a tenotomy. The tough and recalcitrant Achilles Tendon is severed. That loosens the foot for positioning before the final cast, which stays on for three weeks to give the Achilles time to heal. When the cast comes off, a child’s foot — and life — is on the path toward normal.

Following casting the child’s foot position needs to be maintained by wearing the Ponseti foot abduction brace. The foot abduction brace, is the only successful method of preventing a relapse, when used consistently as described is effective in greater than 95% of the patients.

The Ponseti Method is explained further in question & answer form on Ten Questions to ask your doctor.

How to find a Ponseti Doctor:

Surgeons with limited experience in the treatment of clubfoot should not attempt to correct the deformity. Referral to a center with expertise in the non-surgical correction of clubfoot should be sought before considering surgery.

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