Acta Scientific Orthopaedics (ISSN: 2581-8635)

Research Article Volume 5 Issue 3

Clubfoot Associated with Nail-patella Syndrome. Evolution and Treatment with Ponseti Method

Ey Batlle Ana Maria*, Vinyals Rodriguez Marta and Míguez Gonzalez Paula

Equipo Ponseti Dra. Anna Ey, Clinica Diagonal (Barcelona), Spain

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

Received: December 03, 2021; Published: February 18, 2022


Introduction: The incidence with clubfoot, is about 1 to 7/1000 newborns bat its association with Nail Patella Syndrome has never been reported and there are no series of homogeneous treatment of clubfoot associated with this syndrome. Nail-Patella Syndrome is an hereditary onycho-osteodysplasia which has an incidence rate estimated at 1/45.000 newborns. Patients may have hypoplastic or absent patella, dysplastic elbows and iliac exostoses. There may also be renal and ophthalmic alterations.

Objective: To evaluate function and quality of life in patient with clubfoot associated with Nail-Patella Syndrome treated by Ponseti Technique, and to describe its results.

Materials and Methods: Retrospective study of 4 patients (n = 8 feet) treated by Ponseti Technique. The cases were evaluated with detailed medical history, physical examination, total number of casts made for the foot correction, associated complications, description of associated onychopathies, initial correction obtained (Pirani Score), percentage of percutaneous Achilles tenotomy performed, recurrence rate of relapses, tolerance of abduction braces and morphology and foot function. For statistical analysis Chi-square test have been used. Chi-square tests were used in comparison with categorical variables, and expressed as numbers and percentages.

Results: Follow up 4-14y. All cases required between 3-4 casts. All cases required percutaneous Achilles tenotomy. No patient has suffered signs of deformity relapse. According to Laaveg-Ponseti scale, the functional results obtained are 98.6/100. No patient presents residual deformity or complication of any note. Functionally, all 8 feet are painless.

Conclusions: Ponseti Technique is a good method for treatment of clubfoot associated with Nail-Patella Syndrome. It obtains excellent results without any need for additional aggressive surgical treatment.

Keywords: Nail Patella Syndrome; Clubfoot; Ponseti Method; Syndromic Clubfoot


  1. Ponseti IV. “Congenital clubfoot: Fundamentals of Treatment”. Oxford University Press 2nd January (1996).
  2. Staheli L., et al. “Clubfoot: Ponseti management”. Third edition. (Date last accessed 1 November) (2010).
  3. Laaveg SJ and Ponseti IV. “Long term results of treatment of congenital clubfoot”. Journal of Bone and Joint Surgery 62-A (1980): 23-31.
  4. R Viladot. Anna Ey, 25 Lecciones de patología del pie R. Viladot Voegeli y R Viladot Pericé. III Capitulo de tratamiento de pie equinovaro PUNTO ROJO LIBROS S.L (2020).
  5. Ey Batlle Anna. “Tratamiento del pie equinovaro Revista Española de pie y tobillo”. 31.1 (2017).
  6. Van Bosse HJP. “Challenging clubfeet: the arthrogrypotic clubfoot and the complex clubfoot”. Journal of Children's Orthopaedics 13 (2019): 271-281.
  7. Janicki JA., et al. “Treatment of neuromuscular and syndrome-associated (non-idiopathic)clubfeet using the Ponseti method”. Journal of Pediatric Orthopaedics (2009) 29:393-7.
  8. Moroney PJ., et al. “A single-center prospective evaluation of the Ponseti method in nonidiopathic congenital talipes equinovarus”. Journal of Pediatric Orthopaedics 32 (2012): 636-640.
  9. Abraham J., et al. “Ponseti Casting vs.Soft Tissue Release for the Initial Treatment of Non-idiopathic Clubfoot”. Fronters in Surgery 8 (2021): 668334.
  10. Konrads C., et al. “Nail-patella-syndrome in a young patient followed up over 10 years: relevance of the sagittal trochlear septum for patellofemoral pathology”. SICOT Journal 2 (2016): 26.
  11. Ghoumid J., et al. “Nail-Patella Syndrome: clinical and molecular data in 55 families raising the hypothesis of a genetic Heterogeneity”. European Journal of Human Genetics 24 (2016): 44-50.
  12. Rushabh M Vakharia., et al. “Robotic-Assisted Lateral Unicompartmental Knee Arthroplasty in a Patient With Nail-Patella Syndrome”. Arthroplasty Today 8 (2021): 171e175.
  13. Alvarado D M., et al. “Familial Isolated Clubfoot Is Associated with Recurrent Chromosome 17q23.1q23.2 Microduplications Containing TBX4”. American Journal of Human Genetics 87 (2010): 154-160.
  14. Sanke S., et al. “Nail Patella Syndrome a classic case”. Dermatology Practical and Conceptual 4 (2019): 271.


Citation: Ey Batlle Ana Maria., et al. “Clubfoot Associated with Nail-patella Syndrome. Evolution and Treatment with Ponseti Method".Acta Scientific Orthopaedics 5.3 (2022): 30-33.


Copyright: © 2022 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