Congenital clubfoot: comparing treatment methods and their relapse rates
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Abstract
Clubfoot is one of the most common lower limb congenital abnormalities. The gold standard of clubfoot treatment is the Ponseti Method; however, there are other methods used, such as the Kite Method, unilateral orthotics, and the French Functional Method. However, clubfoot relapse is still common among patients with any form of treatment. Relapse is defined as the gradual return to the cavus, adductus, varus, and equinus deformity that requires further treatment and occurs in up to 40% of patients. These can range from flexible muscle imbalances to rigid deformities. Clubfoot relapse has been shown to cause negative physical, social, and psychological effects on both patients and their families. Therefore, research on the prevention of clubfoot relapse is essential for further understanding of the congenital abnormality. The most common cause of clubfoot relapse with the Ponseti Method is bracing non-compliance. Unilateral orthotics, although new to clubfoot treatment, have been shown to increase bracing compliance and reduce Pirani scores with continued use. The French Functional Method has also shown similar outcomes as the Ponseti Method, with increased lower limb strength and improvements in gait over time. More recent research has discussed a Hybrid Method combining the Ponseti and French Functional Method, however, bracing non-compliance is still a concern with this method. Unilateral orthotics are a promising alternative to traditional bracing in the Ponseti Method. While each treatment method has its advantages, further research is needed to determine the most efficient treatment method before becoming a true alternative to the Ponseti method.
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2025