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Severe clubfoot in older children – no operation necessary

The Ponseti approach to treating clubfoot has been implemented across the globe over the past twenty years and has undoubtedly established itself as a state-of-the-art treatment. Schulthess Klinik was one of the first hospitals in Europe to introduce the Ponseti treatment in 2000. This treatment method makes it possible to completely and perfectly correct clubfoot in infants in the space of around eight weeks.

All that is usually required is the percutaneous (minimally invasive) tenotomy (cutting) of the Achilles tendon according to the Ponseti guidelines – a procedure that is performed without anaesthesia. The minor procedure can be performed without any problems with the child under sedation, with local pain relief applied to the the skin using a lidocaine patch an hour before the procedure and with the parents present.

As a hospital specialising in clubfoot, Schulthess Klinik is also able to treat the condition in older children. In this respect, we always treat incompletely corrected feet or severe relapses conservatively at first. In the case of children who are able to walk, a well-moulded plastic plaster cast that can be worn at intervals of one-two weeks would suffice and the child would be able to enjoy full walking ability and mobility during treatment. This treatment requires a great deal of experience and often has a slightly longer treatment time. Fortunately, even these older children can often be saved from unnecessary and stiffening surgical measures thanks to this approach.

Klumpfuss Behandlung nach Ponseti vorher
This example presents the case of a foot that has already been outwardly operated on but remains severely deformed.
Behandlung eines schweren Klumpfusses mit Unterschenkel-Gips
In the hands of a paediatric orthopaedist with experience in the Ponseti method, it proved possible to treat this foot successfully treated with the cast technique alone.
Klumpfuss-Behandlung nach Ponseti nachher

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