Acta Scientific Orthopaedics (ISSN: 2581-8635)

Research Article Volume 4 Issue 9

Is the Quality of Life, Functionality and Podiatric Evaluation of Adolescents with Clubfoot Treated by Ponseti Method Worse than that of Other Adolescents?

Ey Batlle Ana Maria1*, Moral Benitez Helena2, Vinyals Rodriguez Marta1, Perez Palma Laura2 and Míguez Gonzalez Paula1

1Equipo Ponseti Dra. Anna Ey, Clínica Diagonal, Barcelona, Spain
2Departamento de Podologia Pediatrica y Podología Clínica, Facultad de Podología (UB), Barcelona, Spain

*Corresponding Author: Ey Batlle Ana Maria, Equipo Ponseti Dra. Anna Ey, Clínica Diagonal, Barcelona, Spain.

Received: July 26, 2021; Published: August 09, 2021


Introduction: The Congenital talipes equinovarus (CTEV), also known as clubfoot has an incidence of 1 or 2 per 1.000 live births in Europe. Nowadays, the predominant treatment is Ponseti Method, which includes manipulation and casting.

Objective: To analyses and compare with a control group, the quality of life, function and podiatric measures of the patient with CTEV treated with the Ponseti Method 18 years after treatment.

Materials and Methods: A comparative study of 12 adolescent CTEV patients (19 feet) and a Control. Inclusion criteria in CTEV group: Having being treated with Ponseti method, no surgical releases and more than 18 y.o. Laaveg - Ponseti score and SF - 36 are used for quality of life and functionality. The maximum pronation test, the supination resistance test, Lunge’s test and FPI used as podiatric assessment

Results: Everyone got an evaluation between excellent and good in the Laaveg - Ponseti test. In the SF - 36 questionnaire the results obtained were similar between the groups. but the podiatric evaluation was clearly different. Only 4 from the 12 CTEV patients had been treated by a podiatrist.

Discussion: The study shows similar results between both groups, Concerning the Laaveg - Ponseti test both groups display similar results and in the SF - 36 test the results showed a slight improvement in the Clubfoot group, however the results are not statistically significant. The podiatric evaluation results are different between both groups. Despite function of clubfeet after Ponseti Method in adolescents is very good we can detect mild structural changes with podiatric tests.

Conclusion: In terms on functionality and quality of life there are no significative differences between clubfeet and control cases but podiatric evaluation shows statistical differences between both groups.

Level of Evidence: II Or 2b (Oxford Level of evidence).

Keywords: Clubfoot; Adolescent; Ponseti Method; Function; Quality of Life; Podiatry


  1. Johansson A., et al. “Range of motion in the talo – navicular and the calcaneo – cuboid joints evaluated by ultrasound during clubfoot treatment with normal references to the age of four years”. Journal of Children's Orthopaedics5 (2018): 526-538.
  2. Owen RM and Kembhavi G. “A critical review of interventions for clubfoot in low and middle-income countries: Effectiveness and contextual influences”. Journal of Pediatric Orthopaedics Part B1 (2012): 59-67.
  3. Ey AM. “Tratamiento del pie equinovaro congénito”. Revista Del Pie Y Tobillo1 (2017): 3-14.
  4. Ponseti IV. “Treatment of congenital club foot Concepts Review Treatment of Congenital”. The Journal of Bone and Joint Surgery American 74 (1992): 448-454.
  5. Zionts KE., et al. “The influence of sex and laterality on clubfoot severity”. Journal of Pediatric Orthopaedics (2015): 1-5.
  6. Pavone V., et al. “The etiology of idiopathic congenital talipes equinovarus: A systematic review”. Journal of Orthopaedic Surgery and Research1 (2018): 1-11.
  7. Dobbs MB and Gurnett CA. “Update on clubfoot: Etiology and treatment”. Clinical Orthopaedics and Related Research5 (2009): 1146-1153.
  8. Weymouth KS., et al. “Functional assessment of clubfoot associated with HOXA9, TPM1 and TPM2 variants suggests a potential gene regulation mechanism”. Clinical Orthopaedics and Related Research7 (2016): 1726-1735.
  9. Engell V., et al. “Heritability of clubfoot: a twinstudy”. Journal of Children's Orthopaedics 8 (2014): 37-41.
  10. Chu A., et al. “Clubfoot classification: correlation with Ponseti cast treatment”. Journal of Pediatric Orthopaedics7 (2010): 695-699.
  11. Gao R., et al. “Correlation of Pirani and Dimeglio scores with number of Ponseti cast required for clubfoot correction”. Journal of Pediatric Orthopaedics6 (2014): 639-642.
  12. Jochymek J., et al. “Classification systems to evaluate the clubfoot and their potential use to predict the course and the results of the Ponseti method treatment”. Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca5 (2018): 331-335.
  13. Ponseti I V and Smoley EN. “The classic: Congenital club foot: The results of treatment”. Clinical Orthopaedics and Related Research 467.5 (2009): 1133-1145.
  14. O’Shea RM and Sabatini CS. “What is new in idiopathic clubfoot?” Current Reviews in Musculoskeletal Medicine4 (2016): 470-477.
  15. Ponseti IV., et al. “Pie Zambo: El Método de Ponseti. 3ra. Edition: Global – HELP Organization (2003).
  16. Ponseti IV. “Long – Term Results of Treatment of Congenital Club Foot”. Journal of Bone and Joint Surgery 62-A (1980): 23-31.
  17. Sherbourne CD. “The MOS 36 – ítem short – form health survey (SF – 36). Conceptual framework and ítem selection”. Medical Care 6 (1992): 473-483.
  18. Madariaga IA. “Aspectos estadísticos del Cuestionario de Calidad de Vida relacionada con salud Short Form 50.167 (2008): 147-192.
  19. Fuentes A., et al. “Valoración funcional y de calidad de vida en pacientes tratados con artrodesis de tobillo”. Trauma2 (2010): 102-110.
  20. Alonso J., et al. “La versión española del SF-36 Health Survey (Cuestionario de Salud SF-36): un instrumento para la medida de los resultados clínicos”. Journal Medical and Clinical 104 (1995): 771-776.
  21. Alonso J., et al. “Valores poblacionales de referencia de la versión española del Cuestionario de Salud SF-36”. Journal Medical and Clinical 111 (1998): 410-416.
  22. Pascual Huerta J. “Pie plano, 2º parte. Podomorfos: Boletín Informativo del Colegio Oficial de Podólogos de Canarias (2008): 17-25.
  23. García Campos J., et al. “¿Es el test de pronación máxima fiable?” Revista Española de Podología 1 (2012): 6-8.
  24. Alfaro Santafé JJ., et al. “Resultados del test de Lunge en pacientes con hallux limitus funcional: estudio transversal de casos y controles”. Revista Española de Podología2 (2017): 87-92.
  25. Abad E., et al. “The Foot Posture Index. Análisis y revision”. El Peu4 (2011): 190-197.
  26. Porchea MM., et al. “Mid – term results of Ponseti method for the treatment of congenital idiopathic clubfoot – (A study of 67 clubfeet with mean five year follow – up)”. Journal of Orthopaedic Surgery and Research 6 (2011): 3.
  27. Chueire AJFG., et al. “Treatment of congenital clubfoot using Ponseti method”. Revista Brasileira de Ortopedia (2016).
  28. Cock PR., et al. “Resultados del tratamiento de pie equinovaro congénito con el método de Ponseti”. Colombian Journal of Orthopedics and Traumatology (2018).
  29. Dietz FR., et al. “Long – term Results of Comprehensive Clubfoot Release Versus the Ponseti Method: Which Is Better?” Clinical Orthopaedics and Related Research4 (2014): 1281-1290.
  30. Dobbs MB., et al. “Long-term follow-up of patients with clubfeet treated with extensive soft-tissue release”. Journal of Bone and Joint Surgery American 88 (2006): 986-996.


Citation: Ey Batlle Ana Maria., et al. “Is the Quality of Life, Functionality and Podiatric Evaluation of Adolescents with Clubfoot Treated by Ponseti Method Worse than that of Other Adolescents?".Acta Scientific Orthopaedics 4.9 (2021): 23-30.


Copyright: © 2021 Ey Batlle Ana Maria., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Acceptance rate33%
Acceptance to publication20-30 days

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is May 30, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US