Clubfoot is much more treatable at birth
It is recommended that treatment for clubfoot using the minimally invasive Ponseti method begins in the first few weeks of life – but why is it so important to start treatment early?
In a newborn, the bones in the feet are still forming and when placed in alignment they can remodel to the correct shape. The Ponseti method is extremely effective – in just a few weeks the foot can be stretched and manipulated, then held in a plaster cast, to move it from an inwards and downwards, twisted position to a straightened position ready for walking. This is all possible with skilled manipulation, weekly plaster casts changes, and a very small operation to release the tight tendons at the back of the leg, at very low cost ($500 or less per child covers the entire treatment). A brace during sleep helps keep the foot positioned in correct alignment. This all happens long before the child starts to crawl and walk if started early, giving them the best start to life and the opportunity to grow up able to play, learn and walk with the other children their age from the start.
Treatment according to the same principles of slowly stretching and moving the foot and ankle into the correct position can also be applied in much older children – even into teenage years. However, the treatment after walking age takes much longer, is more expensive as it must be delivered in a specialist centre, and is more likely to require larger surgeries making it inaccessible to most. In addition, children by this stage may already face bullying and exclusion from their communities and have missed out on education due to their feet, which can hinder their development.
