Relapsing and residual clubfoot deformities after the application of the ponseti method: a contemporary review.

Abstract

The Ponseti method is a safe and effective treatment for congenital clubfoot, and radically decreases the need for extensive corrective surgery. But a group of patients will still present with under corrected residual equinovarus deformities despite the proper use of the Ponseti method. About 25% of operated clubfeet will develop recurrence or show a marked residual deformity (recurrent clubfoot); however, in the recent literature, the failure rate of the Ponseti method, defined by the need for corrective surgery, ranges from 3% to 5%. Deformities encountered in patients with residual clubfeet comprise of various degrees of equinus, varus, adduction, supination, cavus, and toe deformity. Joint flexibility or stiffness, tarsal dysmorphism, articular incongruence, and progressive degrees of degeneration may be also present. We try to emphasize the current solutions for these deformities.