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Clubfoot Treatment: Ponseti and French Functional Methods are Equally Effective

Authors
  • Faulks, Shawne1
  • Richards, B. Stephens1
  • 1 Texas Scottish Rite Hospital for Children, Department of Orthopaedics, 2222 Welborn Street, Dallas, TX, 75219, USA , Dallas (United States)
Type
Published Article
Journal
Clinical Orthopaedics and Related Research
Publisher
Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins
Publication Date
Feb 26, 2009
Volume
467
Issue
5
Identifiers
DOI: 10.1007/s11999-009-0754-5
Source
Springer Nature
Keywords
License
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Abstract

Over the past 15 years, the reemergence of nonoperative treatment of clubfeet throughout the world has been profound. Two methods have been utilized—the Ponseti method and, to a lesser extent, the French functional method. Our review presents one institution’s experience using both methods. Satisfactory initial correction was achieved in 95% of idiopathic clubfeet, regardless of method. However, maintenance of the correction was challenging as relapses occurred in 37% of feet treated by the Ponseti method and 29% of feet treated by the French functional method. At an average 4.3 year followup, using either method, posteromedial releases were avoided in 84% of our patients. Using gait analysis to evaluate the function of children treated with these techniques, there was no difference in cadence parameters between the two groups. More of the children treated with the French method walked with knee hyperextension, a mild equinus gait, and mild footdrop. In contrast, more of the patients in the Ponseti group demonstrated mildly increased stance-phase dorsiflexion and a calcaneus gait. Level of Evidence: Level V, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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