The Ponseti Method: What to Expect

There is no need to start the Ponseti method on the first day after birth. Often, parents will start one or two weeks afterward so they can spend some time with their child before undergoing the treatment.

Once started, the Ponseti method consists of two phases. In the first phase, the infant undergoes casting, and in the second phase, the child is required to wear a brace.

During the first phase, doctors gently manipulate or position the foot and apply a cast to correct the foot deformity. Occasionally, if the Achilles tendon is too tight, they will cut the tendon as the final step of deformity correction. If this occurs, it will be the only part of the entire process that is considered surgical, and this minor procedure can be performed either in the operating room or sometimes in the physician’s office. This phase lasts approximately two months, as the typical foot corrects after five casts are applied. The first four casts are applied weekly, and the final cast is kept on for three weeks.

In the second phase, children wear braces for the next three to four years, which requires a higher level of parental involvement. If children do not wear a brace, there is a much higher likelihood that clubfoot deformity will occur. After the typical two months of cast correction, the patient is placed into the clubfoot brace, which consists of special shoes connected by a bar that keep the feet rotated outward. The brace is worn for 23 hours each day for three months, with one hour daily out of the brace for bathing and foot stretching. After three months, patients wear the clubfoot brace at night for the next three to four years. Patients will be asked to return to the clinic every four to six months for an assessment of foot shape, mobility and function.