Plaster Cast Treatment of Clubfoot: The Ponseti Method of Manipulation and Casting

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We report the principles and method developed by Dr. I. V. Ponseti for correction of clubfoot. The aim of the treatment is early and full correction of all components of the deformity by gentle manipulations and well-molded plaster casts. All components of the clubfoot deformity must be corrected simultaneously, not in sequence, except for equinus, which should be corrected last. A percutaneous tendo achillis tenotomy may be needed to facilitate correction of equinus. To prevent recurrences, the corrected feet must be maintained in outward rotation in open shoes attached to a bar for many months. The results, although often not anatomically perfect, as viewed on roentgenograms, are almost perfect clinically and functionally, at least into the fifth decade of the patient's life.

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