Pitfalls and complications in the treatment of clubfoot by the Ponseti method: A literature review

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Abstract

BACKGROUND: At every step of clubfoot treatment using the Ponseti method, pitfalls leading to complications, both minor and potentially dangerous, may occur. Any doctor involved in the treatment of clubfoot may encounter similar difficulties in their practice; however, publications devoted to this problem are limited, and in some cases, experts cannot reach a consensus regarding the interpretation of actions that entail undesirable consequences.

AIM: This study aimed to analyze pitfalls and complications associated with the Ponseti method for the treatment of clubfoot using modern literature data.

MATERIALS AND METHODS: Articles were searched for in PubMed, Science Direct, Google Scholar, and eLibrary databases using the following keywords: idiopathic clubfoot, Ponseti method, serial casting, bracing, Achilles tenotomy, pitfalls, and complications. The search was performed without language restrictions. Most of the studies included were published no more than 10 years ago.

RESULTS: Current literature data present on the pitfalls and complications encountered in the treatment of clubfoot using the Ponseti method. The review also covered associated complications and unfavorable prognostic factors. The restrictive measures during the COVID-19 pandemic have affected the treatment of clubfoot.

CONCLUSIONS: Analysis of the causes of pitfalls and complications and control of unfavorable prognostic factors will help reduce complications of clubfoot treatment using the Ponseti method and optimize orthopedic care for children.

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About the authors

Denis V. Derevyanko

Orthotic and prosthetic rehabilitation center “ORTO-N”

Author for correspondence.
Email: dionis1976@inbox.ru
ORCID iD: 0000-0001-6421-6503
SPIN-code: 5135-2227

MD

Russian Federation, Novorossiysk

Svetlana I. Trofimova

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery

Email: trofimova_sv2012@mail.ru
ORCID iD: 0000-0003-2690-7842
SPIN-code: 5833-6770

MD, PhD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

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2. Figure. The scheme of formation of a pseudoaneurysm as a result of partial damage to the artery during achillotomy: a - partial damage to the artery; b — formation of a hematoma; c — formation of a fibrous capsule. Turbulent blood flow in a hematoma can lead to the extrusion of a pseudoaneurysm (adapted from [43])

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