Patient-reported outcome using EFAS score in skeletally mature clubfoot patients treated at birth with Ponseti's technique.

Abstract

Idiopathic clubfoot is a frequent congenital deformity treated worldwide using the Ponseti method, which has become the gold standard due to its safety, reproducibility, and excellent short-term outcomes. However, long-term patient-reported outcomes in adolescents and young adults treated in infancy remain insufficiently documented. This study evaluates foot health perception in skeletally mature patients who underwent Ponseti treatment during early infancy, using the European Foot and Ankle Society (EFAS) score and the first two questions of the World Health Organization Quality of Life-Brief (WHOQOL-BREF) questionnaire. A retrospective study was conducted on patients older than 14 years who received complete Ponseti treatment for idiopathic clubfoot at a single pediatric university hospital. Clinical and demographic data were collected, and both EFAS and WHOQOL-BREF questionnaires were administered anonymously at follow-up. A total of 28 patients completed the questionnaires. Most reported high satisfaction with overall foot health; 78.5% achieved excellent or good EFAS scores for daily activities, while 89.2% demonstrated excellent sports-related scores. Persistent pain or major functional limitations were uncommon, though a subset reported reduced endurance in common walking activity (21%) and altered gait perception (25%). The majority rated their overall quality of life as good or acceptable according to WHOQOL-BREF responses. Ponseti treatment, combined with long-term follow-up and occasional minor procedures, offers satisfactory long-term outcomes in young adults with idiopathic clubfoot. Although some report reduced walking endurance or gait differences, overall foot health and quality-of-life perception remain high. Further studies are needed to evaluate outcomes later in adulthood.