20 Oct Clubfoot: Nemours Study Evaluates 10-year Follow up of Conservative Treatment

Chris Church

MedicalResearch.com Interview with:
Chris Church MPT
Director, Gait & Motion Analysis Laboratory
Nemours duPont Hospital for Children

MedicalResearch.com: What is the background for this study? Would you briefly describe the condition of clubfoot and arthrogryposis?

Response: Clubfoot is a congenital foot deformity in which the child is born with their foot (or feet) are stiff and in position with the foot pointing down (equinus) and in (inverted).  Idiopathic clubfoot is a condition in which these children only have issues with their feet.  Arthrogryposis is a condition in which children have contractures in multiple parts of their body.  Children with Arthrogryposis often have clubfeet that are tighter and more difficult to treat than the more common idiopathic type.

Idiopathic clubfoot is effectively corrected with a conservative treatment known as the Ponseti method. Recent studies have shown successful short-term correction using Ponseti treatment in the stiffer clubfoot associated with arthrogryposis, but there are few studies analyzing long-term results. This study compares outcomes of the Ponseti method in 10-year-old children with idiopathic clubfoot and clubfoot associated with arthrogryposis.

MedicalResearch.com: Would you describe the Ponseti method? Does it require specialized or complicated training to implement treatment?

Response: Clubfoot was treated with surgery in the past.  Now we use a more conservative treatment that is provided by pediatric orthopedic surgeons and physical therapists.  The Ponseti method involved serial casting in infancy, Achillies tenotomies, and prolonged use of bracing during sleep until age 5 years.

Clubfoot
Nemours Image

Clubfoot
Nemours Image

MedicalResearch.com: What are the main findings?

Response:  A total of 177 children were included, 48 with arthrogryposis (AMC, 93 feet) and 129 with idiopathic clubfoot (IC, 190), with an average age of 9.4 ± 0.9 years. Repeat surgical intervention was used in 33% of IC feet and 44% of AMC feet. Residual equinovarus and limitations in range of motion were present in both clubfoot groups in comparison to typically developing feet (p < 0.05). The foot deformity and PROM restrictions were more severe in children with AMC (p < 0.05). The arthrogryposis group exhibited limited gross motor and global function. (p < 0.001).  In 5-to-10-year comparisons, both subgroups showed more limitations in ankle motion, but improvements in dynamic equinovarus deformity and function at age 10 (p < 0.05).

MedicalResearch.com: What should readers take away from your report?

Response: Ten-year-old children with idiopathic clubfoot who underwent Ponseti treatment achieved global functional outcomes indistinguishable from TDY, despite residual foot deformity.  Ten-year-old children with arthrogryposis had limitations in function, residual deformity and pain, however, the Ponseti method provides sufficient correction to allow for ambulation with largely conservative management for traditionally difficult-to-correct feet. 

MedicalResearch.com: What recommendations do you have for future research as a results of this study?

Response: Continued follow-up with evaluation after growth is complete.

The authors declare no conflicts of interest.

Citation: Abstract presented at AACPDM meeting October 2025

The Ten-Year Outcome of the Ponseti Method in Children With Idiopathic Clubfoot and Arthrogryposis

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Last Updated on October 21, 2025 by Marie Benz MD FAAD