Ponseti Casting is a method of treating a child’s malaligned foot or feet by casting them into a normal position. The technique was developed by Dr. Ignacio Ponseti over 50 years ago. The child is treated with a gentle repositioning of the foot and held in an above-knee cast (from the toes to the mid-thigh). This manoeuvre is repeated approximately 6-8 times, each time for approximately 5 days. The casting is sometimes followed by an Achilles tenotomy, where the chord at the back of the foot is cut to further improve the position of the foot. This small operation is usually performed in the outpatients clinic (the child often does not even need stitches) and the foot is casted for a final time.

Every child is treated individually and their club foot may be more or less severe than other patients. For this reason, the doctor may alter the details of treatment. Once casting is over, the child will be fitted with special shoes fixed to a cross-bar to prevent relapse of the condition. The child will need to wear this full-time (23 hours per day) for the first 2-3 months and then at night and nap time for approximately 4 years.

Applying the casts is not painful, but bring a bottle to the outpatients clinic so that the baby’s upset can be minimised. Use disposable nappies so that leaking is contained- away from the cast. Try to avoid getting the cast wet, so using a sponge bath is best during the period while the cast is on. Fitting clothes over the cast can be difficult, so keep an eye out for bodysuits that snap between the legs, trousers that zip up along the legs or loose tracksuit bottoms.

Club Foot