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J Am Acad Orthop Surg, Vol 11, No 6, November/December 2003, 392-402.
© 2003 the American Academy of Orthopaedic Surgeons
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Nonsurgical Management of Idiopathic Clubfoot

Kenneth J. Noonan, MD and B. Stephens Richards, MD

Dr. Noonan is Associate Professor, Department of Orthopaedic Surgery and Rehabilitation, University of Wisconsin, Madison, WI. Dr. Richards is Professor, Department of Orthopaedic Surgery, University of Texas-Southwestern, and Assistant Chief of Staff, Texas Scottish Rite Hospital for Children, Dallas, TX.

Reprint requests: Dr. Richards, Texas Scottish Rite Hospital for Children, 2222 Welborn Street, Dallas, TX 75219.

Because nonsurgical management was thought not to yield adequate correction and a durable result, most children with idiopathic clubfoot have undergone surgery with extensive posteromedial and lateral release. However, surgical management caused residual deformity, stiffness, and pain in some children; thus, the favorable long-term results with the Ponseti and French methods of nonsurgical management have garnered interest. The Ponseti method consists of manipulation and casting of idiopathic clubfeet; the French method consists of physiotherapy, taping, and continuous passive motion. Careful evaluation of the techniques and results of these two approaches may increase their use and decrease or minimize the use of surgical management and thus the associated morbidity resulting from extensile releases.




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