A number of times people have mentioned to me that their child was or is being treated by the Ponseti method but their story reveals that this is not in fact the case.  All methods of treating clubfeet should start with serial plaster casting but that does not mean it is the Ponseti method.

These questions will help you interview your doctor and make sure they are experienced in the Ponseti Method.

1. When should treatment begin? 
The treatment should begin in the first week or two of life in order to take advantage of the favourable elasticity of the tissues forming the ligaments joint capsules and tendons

2. Do you apply casts from the knee down or a full leg cast? 
The Ponseti method uses FULL leg casts up to the groin and bent at the knee.

wrong

correct

3. How many cast changes are required for correction? 
With the Ponseti method the majority of clubfeet can be corrected in infancy in about six to eight weeks with the proper gentle manipulations and plaster casts. Five to seven plaster casts extending from the toes to the upper thigh with the knees at right angle should be sufficient to correct the clubfoot deformity.

The typical five casts of the Ponseti Method

4. What percentage of your patients require surgery after casting?
If a doctor is using the Ponseti method successfully, he or she should have at least a 90 percent or better success rate. Almost all of his/her patients should be completely corrected using casting and tenotomy procedures only.

5. How long have you been practising using the Ponseti Method? 
This is a procedure that requires experienced hands. To locate a Doctor qualified in the Ponseti method:  Check out this listing

6. How often is the cast changed? 
The cast should be changed every 5 days (with the exception of the final plaster cast which is to be worn for three weeks if a tenotomy is performed).

7. Is it okay to take the babies casts off the night before their next cast change?
No. Babies are growing so fast that casts shouldn't be left off for any length of time, not even overnight.

8. Are any surgical procedures needed to complete the correction? 
A procedure called a tenotomy is usually part of treatment.  Before applying the last plaster cast which is to be worn for three weeks, the Achilles tendon is often cut in an office procedure to complete the correction of the foot. By the time the cast is removed the tendon has regenerated to a proper length.

9. Will the baby's feet be completely corrected and will they stay corrected? 
After two months of treatment with the Ponseti method the the foot should appear overcorrected due to the fact that following correction the clubfoot deformity tends to relapse.  To prevent relapses, when the last plaster cast is removed a splint must be worn full-time for two to three months and thereafter at night for 2 to 4 years.

10. What type of splint do you use?
The one used by Dr Ponseti is the Ponseti AFO Brace, also known as the Mitchell Brace. (read more...)  The Ponseti AFO (Ankle Foot Orthotic) should not be confused with the hard rigid molded plastic splint held on with velcro. This type of AFO was used for clubfoot surgical treatment methods and is not part of the Ponseti Method.