Children and Medicine

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Surgery or Casting? February 6, 2011

Filed under: Anna — Anna @ 3:55 am

There are two common methods for treating clubfoot. The first modern method designed is a surgical treatment that combines surgery and casting in order to place the foot in its proper position. The second modern method is the Ponseti Methods developed by Ignacio Ponseti of Iowa that is essentially placing the foot in a series of cast where each cast forces the foot in a slightly different position until the final cast places the foot in the expected position. This method usually means that children require no surgery although some children may have an issue that simply casting won’t fix. In these cases, the repair is often done in a simple procedure that does require general anesthetics (Adegbehingbe, et al 1). This method was not new had in fact been practiced since the time of Hippocrates and even before, according to Dr. Ponseti and his colleagues (Dobbs, et. al 1)

The typical cuts made during surgery to repair clubfoot.


Dr. Ponseti Demonstrating his technique.

Manystudies have been done comparing these two methods, many in countries such as Nigeria where controversy often surrounds physcians who attempt to change the status quo. Children were split into two groups and each group was treated for their clubfoot. One group’s treatment consisted mostly of surgery with occasional minor casting while the other group’s treatment consisted of casting with minor surgery only done where absolutely necessary. According to Dr. Adegbehingbe and his colleagues, the Ponseti method produced more efficient results, with fewer problems for the children and their families and lower costs for the hospital and families (Adegbehingbe 1). This is just one study but many have been done and the results seem to agree that the method that subjects children to less anesthesia and does not mean cutting the tendons produces better results. Below is a method that explains about the spreading of the Ponseti method and Ponseti’s goals in spreading his methodology.

I believe that the Ponseti method is a better way of treating clubfoot. It does not subject children to the risks of general anesthesia such as breathing problems. It also means that the tendons are not cut and there is no risk of scar tissue forming around the tendons. With the Ponseti method, there is a risk of the clubfoot reoccurring although it is usually slight and nightly brace wearing cuts down on the risk.


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