{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T06:37:27Z","timestamp":1780468647470,"version":"3.54.1"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:p>Complex idiopathic clubfeet are distinguished by significant shortening, rigid equinus with a deep crease above the heel, severe plantar flexion of all metatarsals, a deep plantar crease seven across the full width of the sole of the foot and high cavus with a short and hyperextended big toe. Ponseti has devised a modified technique for treating complex clubfeet. We retrospectively identified 11 children (nine males and two females) with 17 complex clubfeet who were treated with the modified Ponseti method. Demographics, severity of clubfoot, number of casts, rate of tendoachilles tenotomy, relapse rate and their management, any additional procedures and data on complications were collected. The average follow-up was 7 years (range 3\u201311 years) and the average Pirani score was 5.5 (range 4.5\u20136.0). Initial correction was achieved in all children, with an average of 7 (range 5\u201310) Ponseti casts. Tendoachilles tenotomy was performed in all 17 feet (100%). The overall relapse rate was 53% (nine feet). Five relapses were managed successfully with repeat casting and four feet were subjected to a second tendoachilles tenotomy. Four feet required extensive surgical releases. A satisfactory outcome was achieved at the final follow-up in 13 of 17 feet (76.5%). Two of these children (two feet) required an additional tibialis anterior transfer. In our experience, the modified Ponseti method is an effective first-line treatment for complex idiopathic clubfoot; however, such children will often require more casts than usual and have a higher rate of tendoachilles tenotomy and a higher risk of relapse requiring surgical procedures. Level of Evidence: level IV.<\/jats:p>","DOI":"10.1097\/bpb.0000000000000321","type":"journal-article","created":{"date-parts":[[2016,4,22]],"date-time":"2016-04-22T13:04:01Z","timestamp":1461330241000},"page":"137-142","source":"Crossref","is-referenced-by-count":33,"title":["Treatment of complex idiopathic clubfoot using the modified Ponseti method: up to 11 years follow-up"],"prefix":"10.1097","volume":"26","author":[{"given":"Hosam E.","family":"Matar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Beirne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin E.","family":"Bruce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neeraj K.","family":"Garg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20230828","doi-asserted-by":"crossref","first-page":"424","DOI":"10.3109\/17453679209154759","article-title":"Incidence of congenital clubfoot in Sweden. 128 cases in 138\u2009000 infants 1946\u20131990 in Malm\u00f6","volume":"63","author":"Danielsson","year":"1992","journal-title":"Acta Orthop Scand"},{"key":"R2-20230828","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1542\/peds.113.2.376","article-title":"Radical reduction in the rate of extensive corrective surgery for clubfoot using the Ponseti method","volume":"113","author":"Morcuende","year":"2004","journal-title":"Pediatrics"},{"key":"R4-20230828","doi-asserted-by":"crossref","first-page":"2261","DOI":"10.2106\/00004623-196345020-00004","article-title":"Congenital clubfoot: the results of treatment","volume":"45","author":"Ponseti","year":"1963","journal-title":"J Bone Joint Surg Am"},{"key":"R5-20230828","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1097\/01.blo.0000224062.39990.48","article-title":"Treatment of the complex idiopathic clubfoot","volume":"451","author":"Ponseti","year":"2006","journal-title":"Clin Orthop Relat Res"},{"key":"R6-20230828","doi-asserted-by":"crossref","first-page":"22","DOI":"10.2106\/00004623-200401000-00005","article-title":"Factors predictive of outcome after use of the Ponseti method for the treatment of idiopathic clubfeet","volume":"86-A","author":"Dobbs","year":"2004","journal-title":"J Bone Joint Surg Am"},{"key":"R7-20230828","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1111\/j.1469-8749.2008.03016.x","article-title":"Impact of congenital talipes equinovarus etiology on treatment outcomes","volume":"50","author":"Gurnett","year":"2008","journal-title":"Dev Med Child Neurol"},{"key":"R8-20230828","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s00402-005-0070-9","article-title":"Ponseti technique for the correction of idiopathic clubfeet presenting up to 1 year of age. A preliminary study in children with untreated or complex deformities","volume":"126","author":"G\u00f6ksan","year":"2006","journal-title":"Arch Orthop Trauma Surg"},{"key":"R9-20230828","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1302\/0301-620X.88B10.17578","article-title":"Treatment of idiopathic club foot using the Ponseti method. Initial experience","volume":"88","author":"Changulani","year":"2006","journal-title":"J Bone Joint Surg Br"},{"key":"R10-20230828","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.1302\/0301-620X.96B10.33612","article-title":"The effect of a dedicated Ponseti service on the outcome of idiopathic clubfoot treatment","volume":"96-B","author":"Mayne","year":"2014","journal-title":"Bone Joint J"},{"key":"R11-20230828","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1302\/0301-620X.88B8.17482","article-title":"The role of the Pirani scoring system in the management of club foot by the Ponseti method","volume":"88","author":"Dyer","year":"2006","journal-title":"J Bone Joint Surg Br"},{"key":"R12-20230828","article-title":"A reliable method of clinically evaluating a virgin clubfoot evaluation","author":"Pirani","year":"1999","journal-title":"21st SICOT Congress"},{"key":"R13-20230828","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1097\/BPO.0000000000000248","article-title":"Factors predictive of second recurrence in clubfeet treated by ponseti casting","volume":"35","author":"Luckett","year":"2015","journal-title":"J Pediatr Orthop"},{"key":"R14-20230828","first-page":"55","article-title":"Relapsing clubfoot: causes, prevention, and treatment","volume":"22","author":"Ponseti","year":"2002","journal-title":"Iowa Orthop J"},{"key":"R15-20230828","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1007\/s11999-014-3463-7","article-title":"Results of clubfoot management using the Ponseti method: do the details matter? A systematic review","volume":"472","author":"Zhao","year":"2014","journal-title":"Clin Orthop Relat Res"},{"key":"R16-20230828","doi-asserted-by":"crossref","first-page":"245","DOI":"10.4055\/cios.2014.6.3.245","article-title":"Relapse of clubfoot after treatment with the Ponseti method and the function of the foot abduction orthosis","volume":"6","author":"Zhao","year":"2014","journal-title":"Clin Orthop Surg"}],"container-title":["Journal of Pediatric Orthopaedics B"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/01202412-201703000-00007","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T19:24:36Z","timestamp":1693250676000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01202412-201703000-00007"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.1097\/bpb.0000000000000321","relation":{},"ISSN":["1060-152X"],"issn-type":[{"value":"1060-152X","type":"print"}],"subject":[],"published":{"date-parts":[[2017,3]]}}}