Idiopathic clubfoot treated by Ponseti method: a series of 300 cases


  • Sunil Kumar Bhatiwal Department of Orthopaedics, Sardar Patel Medical College, Bikaner, Rajasthan
  • B. L. Chopra Department of Orthopaedics, Sardar Patel Medical College, Bikaner, Rajasthan
  • B. L. Khajotia Department of Orthopaedics, Sardar Patel Medical College, Bikaner, Rajasthan
  • Shakti Chauhan Department of Orthopaedics, Sardar Patel Medical College, Bikaner, Rajasthan



Clubfoot, Pirani score, Ponseti technique


Background: Clubfoot is a complicated deformity of the foot. It is one of the commonest congenital deformities in children. The main aim of this study was to evaluate the efficacy management of clubfoot by Ponseti method.

Methods: This prospective study included 300 children (456 club feet) below the age of 2 years with idiopathic clubfeet from January 2013 to December 2017. In all the cases the Ponseti method was used for the management. The severity of the deformity was assessed with the help of the Pirani score and clinical evaluation of the foot was done.

Results: Out of 300 patients 204 patients were male and 96 patients were female and 144 were unilateral clubfoot and 156 were bilateral cases of clubfoot. The mean number of casts required for correction was 5.4 (4–10). Out of 456 clubfeet 356 (78%) feet were required tenotomy. There was relapse seen in 36 (7.9%) feet which had to be managed with 2–3 serial manipulations and casting and these resolved. Excellent result found in our study in 92% cases, good results were found in 5% cases and poor results were found in 3% cases.

Conclusions: Ponseti technique is a very useful and effective method of management of idiopathic clubfoot up to 2 year of age.

Author Biography

Sunil Kumar Bhatiwal, Department of Orthopaedics, Sardar Patel Medical College, Bikaner, Rajasthan

Junior resident ,department of orthopaedics,Sardar patel medical college


Morcuende JA, Weinstein SL, Dietz FR, Ponseti I. Plaster Cast Treatrment of Clubfoot: The Ponseti Method Of Manipulation And Casting. J Pediatr Orthop. 1994;3(2):161-7.

Turco, Vincent J. Clubfoot. New York: Churchill Livingstone; 1982: 1 edition.

Mittal R, Sekhon AS, Singh G, Thakral H. Presence Of Congenital Orthopaedic Anomalies In Rural Community. Int Orthop. 1993;17(1):11-2.

Staheli L. Clubfoot: Ponseti Management, Global HELP Organization, 3rd Edition. 2009.

Ponseti IV. Current Concepts Review- Treatment of Congenital Clubfoot. J Bone Joint Surg Am. 1992;74(3):448-54.

Pirani S. Outerbridge HK, Sawatrky B. Stothers K. A Reliable Method Of Clinically Evaluating A Virgin Clubfoot Evaluation. 21st Sicot World Congress, Sydney, Australia. 1999.

Dobbs M, Rudzki JR, Purcell DB, Walton T, Porter KR, Gurnett CA. Factors Predictive Of Outcome After Use Of Ponseti Method For Treatment Of Idiopathic Clubfoot. J Bone Sugery Am. 2004;86(1):22-7.

Ikeda K Conservative Treatment Of Idiopathic Clubfoot. J Peadiatric Orthop. 1992;12:217-23.

Lehman WB, Mohaideen A, Madan S, Scher DM, Van Bosse HJ, Iannacone M. A Method For The Early Evaluation Of The Ponseti (Iowa) Technique For The Treatment Of Idiopathic Clubfoot. J Pediatr Orthop. 2003;12(2):133-40.

Hallaj-Moghaddam M, Moradi A, Ebrahimzadeh MH, Habibzadeh Shojaie SR. Ponseti Castings For Severe Clubfoot Deformity; Are Clinical Outcomes Promosing? Adv Orthop. 2015;2015:821690.

Abdelgawad AA, Lehman WB, Van Bosse HJ, Scher DM, Sala DA. Treatment of Idiopathic Clubfoot Using The Ponseti Method: Minimum 2 Years Follow-Up. J Pediatr Orthop. 2007;16:98-105.

Ponseti IV. Eugene Ns. Congenital Clubfoot; The Result Of Treatment. J Bone Joint Surg. 1963;45:2;261-75.

Chesney D, Barker S, Miedzbrodzka Z, Haites N, Maffuli N. Epidemiology And Genetic Theories In The Etiology Of Congenital Talipes Equinovarus. Bull Hosp Joint Dis. 1999;58:59-64.

Lochimiller CL, Johnston D, Scott A, Risman M, Hecht JT. Genetic Epidemiology Study of Idiopathic Talipes EquinoVarus. Am J Med Genet. 1998;79:90-6.

Wynne Dr. Genetic And Environmental Factors In The Etiology Of Talipes Equinovarus. Clin Orthop. 1972;84:9-13.

Wallander H, Hovelius L, Michaelsson K. Incidence of Congenital Clubfoot In Sweden. Acta Orthop. 2006;77(6):847-52.

Byron –Scott R, Sharpe P, Hasler C, Cundy P, Hirte C, Chan A, et al. A South Australian Population – Based Study Of Congenital Talipes Equinovarus. Pediatr PerinatEpidemiol. 2005;19:227-37.

Zosia M. Congenital Talipes Equinovarus: A Disorder Of The Foot But Not Hand. J Anat. 2003;202(1):37-42.

Ponseti IV. Clubfoot Management. Editorial. J Pediatric Orthopaedics. 2000;20:699-700.

Ponseti IV. Relapsing Clubfoot: Causes, Prevention And Treatment. Lowa Orthop J. 2002;22:55-6.

Porecha MM, Parmar DS, Chavda HR. Midterm Results Of Ponseti Method For The Treatment Of Congenital Idiopathic Clubfoot (A Study Of 67 Clubfeet With Mean Five Year Follow Up). J Orthop Surg Res. 2011;12:3.

Bor N, Coplan JA, Herzenberg JE. Ponseti Treatment For Idiopathic Clubfoot: Minimum 5 Year Follow Up. Clin Orthop Relat Res. 2009;467:1263-70.






Original Research Articles