REVIEW  PEDIATRIC ORTHOPEDICS 

Minerva Ortopedica e Traumatologica 2019 March;70(1):11-8

DOI: 10.23736/S0394-3410.19.03900-6

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Congenital Clubfoot: from the Ponseti to the French Physical Therapy and “hybrid” methods with “surgery à la carte”

Alain DIMEGLIO ¹, Federico CANAVESE ² ✉, Antonio ANDREACCHIO ³, Flavia ALBERGHINA ³

¹ Faculty of Medicine, University of Montpellier, Montpellier, France; ² Department of Pediatric Surgery, University Hospital Estaing, Clermont Ferrand, France; ³ Department of Pediatric Orthopedic Surgery, Regina Margherita Children’s Hospital, Turin, Italy

Clubfoot has multiple clinical facets. Conservative treatment of clubfoot has established itself as the primary treatment of choice; that is the treatment by plasters, the method of Ponseti, or by manipulations, the French functional physical therapy method. Both protocols aim to achieve a pain-free supple plantigrade foot with as little surgery as practicably possible, and to decrease the risk of relapse. Surgical treatment is only needed when the orthopedic treatment is no longer effective and it should be limited to an “à la carte” approach. With an “à la carte” approach, surgery should be considered as a complementary procedure to non-operative treatment, which aims to reduce the extent of surgery in case it is requested. To achieve a long-term correction with a foot that is fully functional and pain free, a combination of approaches that applies the strengths of Ponseti and French functional physical therapy method is needed (“hybrid method”). The purpose of our review was to summarize the principles of clubfoot treatment using the Ponseti method, the French physical therapy method or the ‘hybrid’ method.

KEY WORDS: Clubfoot - Conservative treatment - Physical therapy modalities - Surgical procedures, operative