Clubfoot | Treatments

What are the treatment options for clubfoot?

‘Ponseti’ method

Our standard of care for clubfoot is the “Ponseti” method, in which the foot is manipulated into correct position without joint surgery. Usually begun immediately after birth, the method involves:

  • a two to three-month regimen of stretching/overstretching and repositioning using casts that get changed every few weeks
  • for about 95 percent of babies, when the casting period is over, surgery (tenotomy) to release and lengthen the Achilles heel; this procedure is performed at Children's usually under local anesthesia
  • a bracing regimen (see description, next paragraph) that lasts for several years — a crucially important step, requiring full family attention and compliance

Learn more about our care tips for cast maintenance.

Bracing treatment for clubfoot

Doctors at Boston Children's stress that the bracing component of the treatment for clubfoot is absolutely critical. The bracing program is full-time (about 22 hours a day) until the baby is about 6 months of age. At 6 months, we generally scale back to bracing just at night and at nap time — about 15 or 16 hours a day — and the baby goes without the brace while he's awake. When the baby is ready to learn how to crawl, and then walk, run and play, the brace is off. 

Strictly following the bracing program until the child is about 4 years old (despite the understandable inconvenience) is the best prevention against recurrence and the need for further intervention.