We often think that high-tech, surgical methods are the best approach when it comes to medical care. But for children born with clubfoot, there is growing, worldwide interest in a low-tech, non-surgical method of treatment that is more effective, less expensive and easier to provide than surgery.

Ponseti International, the University of Iowa-based organization that promotes the technique, will hold a symposium Sept. 12 to 14 at the Marriott Coralville Hotel and Convention Center in Coralville, Iowa. Nearly 200 physicians and other health care providers, representing at least 30 countries, have signed up to attend the event that will explore research, patient care and education.

Representatives from the World Health Organization (WHO), the National Institutes of Health (NIH) and the Centers for Disease Control (CDC) will attend, and conference attendees are expected to reach a consensus/recommendation on the technique. The event will be followed by the annual hands-on training for potential practitioners on Saturday, Sept. 15.

A related event, the fourth annual Ponseti Clubfoot Races, will be held at 6:30 p.m. Friday, Sept. 14, at the Marriott.

Clubfoot causes the feet to turn inward and downward and affects nearly 150,000 babies each year. More than 50 years ago, early in his UI career, Ignacio Ponseti, M.D., realized that surgical approaches were not successful. Ponseti, now emeritus professor of orthopaedics and rehabilitation at the UI Roy J. and Lucille A. Carver College of Medicine, set about developing the method that now bears his name.

The Ponseti Method involves gentle, manual manipulation of the child's foot and application of toe-to-groin plaster casts. The casts are changed weekly after a clinician manipulates softened foot ligaments to gradually achieve near-normal muscle and bone alignment. An essential advantage of the treatment is that it can be taught to nonphysician health care providers, making it an effective treatment in areas with few or no doctors. Nearly 80 percent of children born with clubfoot live in impoverished nations.

In addition to finding ways to take the treatment to those countries, the conference also will address increasing awareness and use of the method in countries with better health care, where surgery is used. Currently, only about half the orthopedists in the United States are actively using the Ponseti Method, which has documented results and peer-reviewed research to show that it is more than 95 percent effective.

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The symposium is funded by the NIH (National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Child Health and Human Development, and Office of Rare Diseases), the Ponseti International Association, UI Department of Orthopaedics and Rehabilitation, the John and Ellen Buchanan Foundation, the Judge William C. Hanson Pediatric Orthopaedic Research Fund, Roger and Bridget Ryan Berman, and John and Willetta Murphy.

Collaborating organizations include the WHO, CDC National Center on Birth Defects and Developmental Disabilities, U.S. Bone and Joint Decade, American Academy of Orthopaedic Surgeons, American Academy of Pediatrics, European, Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America and Shriners Hospitals for Children,

The event sponsors are the UI Carver College of Medicine, UI Department of Orthopaedics and Rehabilitation, and the UI College of Public Health.

For more information, visit itreoh/clubfoot/.

Source: Becky Soglin
University of Iowa