Foot

Clubfoot

Name: Clubfoot Milan: Ponseti Method, Serial Casting and Results
Creator: Dott. Daniele Priano
Published: 2026-01-15

Treatment of congenital clubfoot with Ponseti method.

Medically reviewed: April 2026·Dott. Daniele Priano

Quick Answers

Can clubfoot be seen before birth?

Yes, in many cases it is diagnosed during the second-trimester morphology ultrasound. Prenatal diagnosis does not change prognosis but allows parents to prepare and organize treatment in the very first days of life, when the Ponseti method gives the best results.

How long does Ponseti method treatment last?

The corrective phase with casts lasts on average 5-8 weeks (one cast per week). It is followed by percutaneous Achilles tenotomy and a final 3-week cast. Maintenance phase with the Denis Browne brace then begins, continuing for 4-5 years — initially full-time, then nighttime only.

What happens if my child doesn't wear the brace?

Adherence to the Denis Browne brace is the most important prognostic factor: lack of compliance is the leading cause of recurrence. Children who don't wear the brace properly have up to 70% risk of recurrence, versus less than 10% for those using it regularly. This is why family education and support are integral to treatment.

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Clubfoot - Pediatric Orthopaedics Milan Dr. Priano

Congenital clubfoot is a malformation involving bones, joints and soft tissues of the foot. The Ponseti method, based on serial manipulations and corrective casts, represents the therapeutic gold standard and achieves functional feet in most cases.

✨The Ponseti Method Works

Congenital clubfoot, when treated early with the Ponseti method, has excellent results. Serial casting and night bracing allow achieving a functional foot without major surgery in most cases. Early treatment initiation, in the first weeks of life, is crucial.

When to seek evaluation

Prenatal diagnosis of clubfoot
Clubfoot evident at birth
Foot deformity in newborn
Foot rigidity in equino-varus-adductus-supinatus
Follow-up after initial treatment

What is evaluated

Deformity classification (Pirani score)
Component reducibility evaluation
Exclusion of syndromic forms
Monitoring during treatment
Long-term result evaluation

Treatment options

Ponseti method: serial manipulations and casts
Percutaneous Achilles tendon tenotomy
Denis Browne brace for maintenance
Tibialis anterior transfer in recurrences

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When Surgery Is Needed

Il metodo Ponseti (manipolazioni + gessetti) è il gold standard e risolve la maggior parte dei piedi torti senza chirurgia maggiore. Tuttavia, alcune procedure chirurgiche fanno parte integrante del protocollo o sono necessarie in caso di recidive.

🔗View surgical options for this condition →

Frequently Asked Questions

Can clubfoot be seen before birth?▼

How long does Ponseti method treatment last?▼

What happens if my child doesn't wear the brace?▼

Will my child operated on for clubfoot be able to play sports?▼

Yes. Children correctly treated with the Ponseti method generally achieve excellent function and can play sports normally, even competitively. Slight differences in volume or stiffness compared to the healthy foot may persist, but rarely affect daily or sports activities.

Important Notice: The information on this page is for educational and informational purposes only and does not constitute medical advice. Each clinical case is unique: the appropriate treatment is determined during the specialist consultation, based on a thorough clinical examination and, where necessary, diagnostic imaging. For any doubts or concerns, please consult a specialist.