• Muhammad Qaisar Shah Deapartment of Orthopaedics, ATH
  • Alamzeb Khan
  • Muhammad Shoaib Zardad
  • Rizwana Iqbal
  • Sajjad Ahmed


Background: Clubfoot or congenital talipes equinovarus, is a congenital deformity of the foot. It consists of cavus, adduction, varus and equinus. This is due to medial displacement of navicular and calcaneus around the talus. Talus is in equinus. Medial deviation of the head and neck of talus is due to force of calcaneus on talus. Methods: This descriptive case series study was conducted at Orthopaedic unit, Ayub Teaching Hospital, Abbottabad from 1st August 2015 to 31st January 2016 to determine the frequency of idiopathic clubfoot correction, by using the Ponseti method. A total of 177, unilateral and bilateral clubfeet, from both genders were studied. Patients between age of 2 weeks to 2 years were included in the study. Basic pirani score six (06) who were previously untreated were included in the study. Syndromic patients, previously treated and patients with associated neuro-mascular disorders were excluded from the study. Patients who were corrected with serial castings, were put in foot abduction brace. Those who needed some sort of surgery, underwent surgery. All the data was collected in the proforma and analysed by SPSS version 16.00. Results: A total of 177 clubfeet were included in the study. Mean age of the patients was 10.28±7.45 ranging from 2 weeks 2 years. There were 93 (52.5%) male and 84 (43.5%) female out of total 177 patients. Of these 20 patients were corrected with serial casting only while 150 patients underwent percutaneous tenotomy, which is a minor procedure and done on out –patient department basis. After correction, the feet were put in 70 degree of abduction in abduction brace. Only 7 patients required some sort of surgery, more than tenotomy. Conclusion: Ponseti is very effective, economical and non-invasive way of treating congenital idiopathic clubfoot. only resistant cases may need some sort of extensive surgery. Keywords: Clubfoot; Ponseti method; Pirani score


Kelly DM. Congenital anomalies of the lower extremity. In: Canale ST, Beaty JH, editors. Campbell`s operative orthopaedics. 12th ed. Philadelphia, PA: Elsevier Mosby; 2013. p.994–1012.

Shabtai L, Specht SC, Herzenberg JE. Worldwide spread of the Ponseti method for clubfoot. World J Orthop 2014;5(5):585–90.

Hui C, Joughin E, Nettel-Aguirre A, Goldstein S, Harder J, Kiefer G, et al. Comparison of cast materials for the treatment of congenital idiopathic clubfoot using the Ponseti method; a prospective randomized controlled trial. Can J Surg 2014;57(4):247–53.

Kim S, Goldstein RY, Park J, Shapiro P, Yoo AE, Sala DA, et al. Idiopathic clubfoot treated with Ponseti method: factors associated with patient follow-up. Bull Hosp Joint Dis 2014;72(3):204–9.

Zionts LE, Packer DF, Cooper S, Ebramzadeh E, Sangiorgia S. Walking age of infants with idiopathic clubfoot treated using Ponseti method. J Bone Joint Surg Am 2014;96(19):e164.

Opel D, Abrams S, Halanski M, Noonan K. Lateral Intra-Articular Transposition of the Anterior Tibialis Tendon for the Treatment of Relapsed Clubfoot in Toddlers: A Previously Unreported Surgical Technique. Open J Orthop 2014;2014.

Morcuende JA, Dolan LA, Dietz FR, Ponseti IV. Radical reduction in the rate of extensive corrective surgery for clubfoot using the Ponseti method. Pediatrics 2004;113(2):376–80.

Porecha MM, Parmar DS, Chavda HR. Mid-term 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;6:3.

Lourenco AF, Morcuende JA. Correction of neglected idiopathic club foot by the Ponseti method. J Bone Joint Surg Br 2007;89(3):378–81.

Gianluca Testa VP, Alberghina F. Effectiveness of Ponseti method for the treatment of congenital talipes equinovarus: personal experience. Pediatr Ther 2015;5(3):1000260.

Mercuende JA, Dobbs MB, Frick SL. Results of the Ponseti method in patients with clubfoot associated with arthrogryposis. Iowa Orthop J 2008;28:22–6.

Ostadal M, Chomiak J, Dungl P, Frydrychova M, Burian M. Comparison of the short term and long term results of the Ponseti method in the treatment of Idiopathic pes equinovarus. Int Orthop 2013;37(9):1821–5.



Most read articles by the same author(s)

1 2 > >>