Laaveg and Ponseti report 10-27 year outcomes in 70 patients (104 feet) treated with the Ponseti method. The study asks whether serial casting, selective Achilles lengthening, Denis Browne bracing, and anterior tibial tendon transfer for relapse yields functional, painless adult feet. It is the foundational long-term validation of the Ponseti technique.
A family asks whether their child will have a functional foot after Ponseti treatment. This paper gives you the numbers: 9 in 10 patients are satisfied, and 74% achieve good-to-excellent results at nearly two decades of follow-up.
When you assess post-treatment radiographs, look at the lateral talocalcaneal angle. It is the only x-ray measurement that tracks with function and satisfaction. An abnormal AP talocalcaneal angle in isolation does not predict poor outcomes.
Do not equate residual stiffness with treatment failure. Reduced dorsiflexion (averaging 13° vs. 31° in normals) is nearly universal in successfully treated feet. The authors are explicit: differences in motion between treatment groups reflect initial deformity severity, not iatrogenic harm.
If a child older than 2.5 years relapses and the anterior tibial muscle is supinating, transfer to the third cuneiform is the indicated next step. This paper establishes it as a relapse preventer — 46% of patients received it after first relapse, 56% after second relapse, with no further clinical recurrences reported thereafter.
Laaveg and Ponseti report 10-27 year outcomes in 70 patients (104 feet) treated with the Ponseti method. The study asks whether serial casting, selective Achilles lengthening, Denis Browne bracing, and anterior tibial tendon transfer for relapse yields functional, painless adult feet. It is the foundational long-term validation of the Ponseti technique.
A family asks whether their child will have a functional foot after Ponseti treatment. This paper gives you the numbers: 9 in 10 patients are satisfied, and 74% achieve good-to-excellent results at nearly two decades of follow-up.
When you assess post-treatment radiographs, look at the lateral talocalcaneal angle. It is the only x-ray measurement that tracks with function and satisfaction. An abnormal AP talocalcaneal angle in isolation does not predict poor outcomes.
Do not equate residual stiffness with treatment failure. Reduced dorsiflexion (averaging 13° vs. 31° in normals) is nearly universal in successfully treated feet. The authors are explicit: differences in motion between treatment groups reflect initial deformity severity, not iatrogenic harm.
If a child older than 2.5 years relapses and the anterior tibial muscle is supinating, transfer to the third cuneiform is the indicated next step. This paper establishes it as a relapse preventer — 46% of patients received it after first relapse, 56% after second relapse, with no further clinical recurrences reported thereafter.