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Additional info for Treatment Of Congenital Clubfoot Using The Ponseti Method: Workshop Manual
4. Result to expect By using the described modified Ponseti treatment, you can expect successful correction of the feet without the need for extensive corrective surgery. By keeping the correct bracing protocol, the foot's shape, length, motion of the subtalar joint, and dorsiflexion will usually continue to improve a few months after correction. The foot will appear more and more like a normal foot. It is possible that a plantar crease will still be seen after a few months and a minimal cavus deformity might appear which can be passively corrected.
3. Tibialis anterior transfer (TAT) followed by 6 weeks long leg cast. 4. After correction back to sleeping time bracing. REMARK: *Tibialis anterior transfer (TAT) The Tibialis anterior muscle is a strong supinator. This is so because the insertion of the muscle is at the medial part of the foot (Cuneiforme mediale and Metatarsale I). By transferring the tendon to the Cuneiforme laterale the muscle will not work as a supinator any more. The age of the child to perform the TAT should be about 3-5 years.
After 3 months: check-up – 1 year sleeping time bracing done 8. Every 4 months: check-up – until the age of 5 – stop bracing ( if feet are fine) 9. Once a year: check-up – until skeletal maturity c) treatment started around the age of 4 The treatment of these children may differ a lot from the normal management for smaller children. To achieve to some extent a satisfactory correction of the feet, the child may require a transfer of the tibialis anterior tendon or other surgery as well. The treatment and check-up plan needs to be individually planned.