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An estimated 80% of clubfoot cases occur in low to middle-income countries. Incidence of clubfoot is estimated to be 1-1.5 per 1000 births, and male to female occurrence is 3:1. (1) Left untreated, this congenital anomaly becomes a “neglected clubfoot” and can result in lifelong hardships including limited ambulation related to gait deviations, pain, foot deformities and an inability to wear shoes. Without treatment, this health condition can lead to functional limitations with limited independence in activities of daily living and participation restrictions within the family and community related to decreased mobility. (2)

The intervention presented is the main components of the Ponseti approach which consists of a defined sequence of manipulation of the foot followed by a period of casting and, in approximately 90% of the cases, an Achilles tenotomy. Long term follow-up is bracing which continues for 3-5 years after the initial treatment period of manipulation. A comparison of Ponseti and conservative non-Ponseti methods achieved a good to excellent prognosis in an average of 91.6 % vs 76.6% of patients. (3)(4)

Publication Date

Fall 12-13-2019


University of St. Augustine


San Marcos, CA


Clubfoot, Achilles Tendon, Tenotomy, Musculoskeletal Manipulations, Braces


Orthopedics | Pediatrics | Physical Therapy | Physiotherapy


Poster presented at the Fall 2019 Research Day on the San Marcos, CA, campus of the University of St. Augustine for Health Sciences, December 13, 2019.


  1. Global Clubfoot Initiative. What is Clubfoot? Available at: Accessed: Jan. 29, 2018.
  2. Penny, J, The neglected clubfoot. Available at: Accessed: April 14, 2017
  3. He JP, Shao JF, Hao Y. Comparison of different conservative treatments for idiopathic clubfoot: Ponseti's versus non-Ponseti's methods. J Int Med Res, 2017; 45(3): 1190-1199.
  4. Garg, N. Update on clubfoot, Paeds Child Health, 2016; 26(6): 257-260.

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