Ponseti

Ignacio V. Ponseti MD
Dr Ignacio Ponseti developed the Ponseti Method (also known as the Ponseti Technique) to correct congenital clubfoot in the 1950's.

Biography
Dr Ignacio Ponseti is Professor Emeritus of Department of Orthopaedic Surgery at University of Iowa Hospitals and Clinics. Born 3 June 1914 in Menorca, part of the Balearic Islands, Spain. Studied orthopaedics at Barcelona University and left after the breakout of the Spanish Civil War in 1936. After a brief time in Mexico, Ponseti moved to Iowa USA where he completed his specialty in Orthopaedics. Now in his nineties, Dr Ponseti continues to see patients at the clinic named in his honour - as he has for over 65 years. He trains visiting doctors from around the world, develops new prosthetic devices with John Mitchell of MD Orthotics and produces training and information DVD's on the method. Ponseti's 65-year career has not been limited to clubfoot correction. Over the years, he has contributed 140 basic science and clinical articles, mainly focusing on his primary research interests in congenital and developmental bone and joint disorders, skeletal growth disorders in children, and the biochemistry of cartilage. He performed pioneering work in the early 1950s on the effect of amino nitriles on collagen cross linking, defined the curvature patterns of idiopathic scoliosis, and was the first to demonstrate that curves progressed after skeletal maturity. He also conducted many studies evaluating the long-range results of treatments for congenital dislocation of the hip, clubfoot and scoliosis.

The Ponseti Method
"The manipulative treatment of clubfoot deformity is based on the inherent properties of the connective tissue, cartilage, and bone, which respond to the proper mechanical stimuli created by the gradual reduction of the deformity. The ligaments, joint capsules, and tendons are stretched under gentle manipulations. A plaster cast is applied after each manipulation to retain the degree of correction and soften the ligaments. The displaced bones are thus gradually brought into the correct alignment with their joint surfaces progressively remodeled yet maintaining congruency. After two months of manipulation and casting the foot appears slightly overcorrected After a few weeks in splints however, the foot looks normal. Proper foot manipulations require a thorough understanding of the anatomy and kinematics of the normal foot and of the deviations of the tarsal bones in the clubfoot. Poorly conducted manipulations will further complicate the clubfoot deformity. The non-operative treatment will succeed better if it is started a few days or weeks after birth and if the orthopaedist understands the nature of the deformity and possesses manipulative skill and expertise in plaster-cast applications." Reference: UI Healthcare

Clubfoot affects almost 150,000 children annually. Almost 80% of these children live in developing nations. Dr Ponseti's technique is painless, fast, cost-effective and successful in almost 100% of all congenital clubfoot cases. The Ponseti method is endorsed and supported by World Health Organisation, National Institutes of Health, American Academy of Orthopedic Surgeons , Pediatric Orthopaedic Society of North America , European Paediatric Orthopaedic Society , CURE , STEPS Charity UK , STEPS Charity South Africa , and A Leg to Stand On (India) and others.

At the 2007 International Clubfoot Symposium attended by 200 doctors from 44 countries, papers were presented for an estimated 10,000 children successfully treated with the technique around the world in the past few years.

The Ponseti International Association for the Advancement of Clubfoot Treatment was founded in 2006. The Ponseti International Association aims to improve the treatment of children born with clubfoot through education, research and improved access to care.

Publications
The Ponseti method is described in detail in his book: Congenital clubfoot. Fundamentals of Treatment (Oxford University Press), 1996. Available through Dept. of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242. E-mail ignacio-ponseti@uiowa.edu.

Another informative publication is Clubfoot: Ponseti Management. Global-HELP Publications. http://www.global-help.org

Awards
1955 Kappa Delta Award for outstanding orthopaedic research 1960 Ketoen Gold Medal, American Medical Association 1966 Commonwealth Fellowship 1966 Lawrence Pool Prize, University of Edinburgh, Scotland 1975 Shands Award Lecture, Orthopaedic Research Society 1983 Ignacio V. Ponseti International Symposium 1984 Doctor Honoris Causa, Univ. of Barcelona, Barcelona, Spain 1985 Gold Medal, City of Ciutedella, Menorca, Spain 1988 Honorary member, Pediatric Orthopedic Society 2002 American Academy of Orthopaedic Surgeons - award-winning video on Treatment of Congenital Clubfoot 2003 AOA-Zimmer award for Distinguished Contribution to Orthopaedics 2006 Pediatric Orthopaedic Society of North American Award for Distinguished Service 2006 Iowa Orthopaedic Society James J. Puhl, MD, Humanitarian award 2006 European Pediatric Orthopaedic Society Maximum Meritus Medal 2007 Children's Miracle Network award, Orlando, FL

Links
1. University of Iowa website http://www.uihealthcare.com/topics/medicaldepartments/orthopaedics/clubfeet/index.html 2. Ponseti Links (a comprehensive list of links to information about Ponseti