Club foot and the Ponseti technique

Club foot (also known as talipes), is a relatively common condition, affecting 1 in 1000 babies, in which the ankle and foot point down and in towards the opposite leg. It’s a congenital defect, meaning a baby is born with the condition and it can be present in one or both legs.

Cases range from the mild to the severe. In some cases, the foot can appear as if it's upside down. While club foot can look painful, it doesn’t cause discomfort to the infant. However, if left untreated it can lead to arthritis, and problems with walking.

Yes. Clubfoot is treated ideally in the first few weeks of life. We use the Ponseti technique, which has excellent results and is the internationally recognised gold standard.

First, there are a series of cast settings.

Your baby’s foot will be gently and carefully manipulated into position, before being placed in a plaster cast from toes to hip. After a week, we’ll remove the cast, reposition the leg again and then put another cast on.

Usually, four to six cast changes are required before the foot is ready for the next stage of treatment, which is a small procedure usually performed in the clinic to release the tight Achilles tendon.

A few weeks later, the casts are removed and a special foot brace is provided to maintain the improved foot position. This is worn at night until five years of age. Wearing the brace dramatically improves the long-term results of this technique and is a very important part of the treatment.

No. We’ll talk through every stage of the treatment with you, answer any questions you may have, and make sure you’re happy with the proposed pathway at every stage.

It often helps to have toys and a feed on hand to help keep your baby calm during each round of physio.

There are steps you can take to make sure everything goes smoothly after the first cast setting.

• Check your infant’s circulation. If your child’s toes are pink and warm, then the circulation is good.
• Keep the plaster dry. Also make sure that it stays clean, especially when changing nappies.

In a small number of severe cases – or those that don’t respond to the Ponseti technique – surgery can still be the best option. If that is the case, the procedure will usually be carried out when your baby is around 7 to 8 months old.

If this is the case with your child, we’ll take as much time as you need to talk everything through with you, making sure you’re fully involved with the decision-making process and completely comfortable with the proposed treatment pathway.