Correct your baby’s clubfoot with the Ponseti Method

How to correct a clubfoot in 3 steps

What is the Ponseti Method?

The Ponseti Method is not only a way of manipulating and casting, but also a way to avoid and treat recurrences.
A clubfoot in a child who has no other physical defect can be corrected in about 2 months by manipulation and casting without the need for major surgery.
After doing an exhaustive anatomical study, in 1948, Dr. Ignacio Ponseti began to apply his method of plastering to treat clubfoot. With each plaster, the position of the foot corrects. To shorten the duration of the casting period and correct the last component of clubfoot, the equinus, a percutaneous tenotomy of the Achilles tendon is performed.
With this method, a correction rate of 96% is achieved.



pie zambo sin cirugia

With the Ponseti Method you will be able to correct your baby’s clubfoot (pes equinovarus) in 3 steps:

Step 1: Weekly serial casting

In this first phase, every week a plaster will be placed on the clubfoot, so that the malformation will be progressively corrected, for about 2 months.
With the initial plaster, the cavus is corrected, in such a way that the forefoot is aligned with the rest of the foot and the plantar arch is “flattened”. With the following plasters it is possible to correct the adduct (it is possible to straighten the curved foot inwards), the supination (the orientation of the sole of the foot pointing towards the interior is corrected) and the correction of the plantar arch achieved with the first cast. With the application of each plaster there is a significant improvement. It is very important that the plaster is performed by the surgeon and not by another health professional.
During these recurrent processes of plastering and manipulation it is very important that both the baby and his family are comfortable and that the patient is distracted. Therefore, in these sessions, it is recommended to use toys and music, as well as to feed the baby with a bottle or through breastfeeding.

Step 2: Out-patient microsurgery

Once the maximum correction is obtained with the casts of the previous phase, in most cases, it is necessary to make a small cut in the Achilles tendon. This is made up of very dense collagen fibers that can not be stretched.

Therefore, to be able to continue towards the complete recovery of the foot, it is necessary to make a small incision or cut in the Achilles tendon, with a very small scalpel, and under local anesthesia (in cream).

As in the plaster phase, it is important that the child, accompanied by a family member (or one of the parents), be entertained or eating during this process.

After the small intervention of the tendon, a cast is applied, in position of maximum correction, which will be carried out during the following 3 weeks. It is likely that the plaster will stain a bit with blood; however, if it is only a few drops, it is not a cause for concern. On the other hand, if the spot increases in size, you should consult with the specialist.

Step 3: Splinting and follow-up

At 3 weeks, the last cast is removed from the previous phase and into the last stage of treatment. In phase 3, a splint is placed that will maintain and provide stability to the correction achieved with the casts.

From this moment, the family becomes the undisputed protagonist of the therapy and the doctor will only limit himself to assessing the proper use of the splint. It is very important to place the splints in an optimal way and use them according to the indications given by the specialist, since the correct use of the splint limits the chances of suffering a relapse.

The complete procedure includes the following steps:

Pie-zambo-Fase- 1-Colocación-de-yesos-correctores

Phase 1: Placement of weekly corrective plasters

Each week a plaster will be placed on the clubfoot to correct it.


Phase 2: Ambulatory microincision

Once the maximum correction is obtained with the casts of the previous phase, in most cases, it is also necessary to make a small cut in the Achilles tendon.

Pie-zambo-Fase-3- Férula y seguimiento

Phase 3: Splinting (boots and bars) and follow-up

At 3 weeks, the last plaster of the previous phase is removed and we enter the last stage of the treatment. Finally, a orthosis is placed (two boots attached to a bar) to maintain and provide stability of the correction achieved with the casts.

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Why was your baby born with this deformity?
A proven method that corrects your child’s foot in 8 weeks without the need of major surgery.
How you can work with us to guarantee a resolution of up to 96%.

“What memories it brings me!, but my daughter is doing great and thanks to Dr. Downey and as you say, our (the parents) persistence. Lots of encouragement to all those who are starting , they are in good hands”

Mari Angeles Frias

Laura´s Mother, Patient of Clubfoot

+34 954 610 022


Camino del Silo, Expolocal -Sevilla


The Downey Institute is part of the Orthopediatrica Group
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