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In most developed countries in recent times there has been a trend towards early comprehensive surgical correction of clubfoot. The Ponseti Method of clubfoot correction which utilizes non surgical methods for correction has been shown to be effective and affordable treatment for clubfoot in all cultures and societies.

To learn more about the Ponseti method of clubfoot correction please follow these links:

http://www.uihealthcare.com/news/currents/vol1issue1/clubfoot.html

http://www.uihealthcare.com/topics/medicaldepartments/orthopaedics/clubfeet/index.html

The Ponseti Technique

  • The Ponseti technique has been used in similar projects in other third world and developed countries with good effect.  Early detection of clubfoot is critical, as it is important for treatment to occur as soon as possible after birth.
  • Initially treatment is with manipulation and casting. During the first 3 weeks of life ligaments are more pliable which allows the foot to be more easily corrected. There is also a rapid growth period in early infancy and growth is essential for correction when using casting. Casting is needed for 5 -6 weeks, changed every week with manipulation at cast changes.
  • A small surgical procedure is performed prior to the final cast being applied. This can be performed under local anaesthesia and involves lengthening of the Achilles tendon.
  • Once correction has occurred night splints and corrective shoes are used for up to 3-4 years. Unfortunately recurrences can occur. This is more likely if night splints are not used or not used for long enough.
  • Poor treatment results can occur. Large distances people have to travel for treatment can effect compliance, particularly poor families in remote locations. Other problems include skin infection and pressure sores due to casting in tropical environments.
  • Success rates for the correction of clubfoot using the Ponseti method are generally very good. Surgery is a more complicated and expensive option which can correct the deformity but often results in a painful, stiff foot.
  • Vietnam there are a large number of children and adults with untreated clubfoot for which there is no option but to operate. In older children where correction is not possible without surgery a period of time with casting prior to surgery can reduce down the deformity meaning less surgery is required.

 

Estimated Cost Comparison for Clubfoot correction in Vietnam

TreatmentCost
SurgeryAUD$358
Casting and SplintingAUD$116
Casting and splint 3 x more cost effective 

 

 

 
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