<p>June 3rd is the birthday of Dr Ignacio Ponseti, the Spanish-American orthopaedist who practised and popularised a non-surgical, effective, and economical method to treat clubfoot.</p><p>Clubfoot is not polio; clubfoot can be treated and corrected. The term ‘clubfoot’ originates from the resemblance of this birth defect where the feet are twisted inwards and resemble a golf club. Unlike polio, clubfoot is a congenital condition, meaning it is present at birth and cannot be prevented since the reason for clubfoot is not yet medically diagnosed. That said, clubfoot can be effectively corrected, enabling children born with this condition to lead active and productive lives if they receive the appropriate treatment at the right time.</p><p>The Ponseti method is globally recognised as the gold standard for the treatment of clubfoot, and it is in his honour that June 3rd is observed as World Clubfoot Day.</p><p>The Ponseti method involves two phases of treatment. The first phase begins with weekly serial casting, during which the deformed foot is gently manipulated into the correct position, and a plaster cast is applied from the toes to the groin. Each week, a new cast is applied after further manipulation to gradually improve the foot's position. This non-surgical treatment ideally commences within the first week of birth, although positive results can still be achieved if treatment starts within the first three months. Once the feet are corrected to a normal position, the child must wear a special shoe, known as a Foot Abduction Brace, during nighttime for 4-5 years to maintain the correction, and prevent relapse or recurrence of the deformity. After five years of maintaining corrected feet, no further intervention is typically required.</p><p>While surgery was previously a popular method for correcting clubfoot, it has proven to be less effective, often requiring multiple surgeries and failing to achieve the desired correction and functionality of the feet. Even for children who missed early treatment, the Ponseti method remains the preferred approach, with surgery considered only if the desired correction is not achieved or in cases of recurrence due to non-compliance with bracing. As children grow, it is crucial to provide appropriately sized braces to ensure that their feet remain in the corrected position during the night when human bone growth is most active. Once completely corrected, children can run, play, and actively participate in all sports and games.</p><p>In India, government medical colleges, district hospitals, and district early intervention centres have dedicated weekly clubfoot clinics, where the Ponseti method of treatment is provided. Nationally, CURE India focuses on clubfoot and operates across the country with the vision of eliminating disability from this condition.</p><p>Clubfoot might not be getting the media attention other medical conditions get, but that should not let us underestimate the scale of the challenge before us. Globally, over 200,000 children are born with clubfoot each year. In India, based on estimates from different studies and reports we have collected from the field across the country, it can be said that every day a little over 100 babies born (or about 40,000 babies per year) have clubfoot. Left untreated, clubfoot can significantly impact mobility, leading to missed educational opportunities, and access to life that a person without clubfoot enjoys. Dr Mathew Varghese, a Delhi-based orthopaedic surgeon emphasizes the importance of early intervention and comprehensive treatment to prevent disability from clubfoot.</p><p>The Rashtriya Bal Swasth Karyakram (RBSK) programme under the National Health Mission prioritises the early detection and treatment of clubfoot. ASHA workers and Anganwadi teachers are trained to identify and refer children with clubfoot for treatment, while mobile units of the RBSK reach remote areas to identify children who may have missed early intervention opportunities. The government health systems at the grassroots emphasise the importance of providing accurate information to parents in the remote villages to ensure that every child receives appropriate treatment for clubfoot, ultimately aiming for the elimination of disability caused by this condition.</p><p>On this World Clubfoot Day, let us renew our commitment to eliminate one more disability, recognise that clubfoot is a treatable condition, and advocate for comprehensive care to ensure that every child born with clubfoot has the opportunity for a healthy and active life.</p><p><em>(Santhosh G is Director, CURE India, New Delhi.)</em></p><p><em>Disclaimer: The views expressed above are the author's own. They do not necessarily reflect the views of DH.</em></p>
<p>June 3rd is the birthday of Dr Ignacio Ponseti, the Spanish-American orthopaedist who practised and popularised a non-surgical, effective, and economical method to treat clubfoot.</p><p>Clubfoot is not polio; clubfoot can be treated and corrected. The term ‘clubfoot’ originates from the resemblance of this birth defect where the feet are twisted inwards and resemble a golf club. Unlike polio, clubfoot is a congenital condition, meaning it is present at birth and cannot be prevented since the reason for clubfoot is not yet medically diagnosed. That said, clubfoot can be effectively corrected, enabling children born with this condition to lead active and productive lives if they receive the appropriate treatment at the right time.</p><p>The Ponseti method is globally recognised as the gold standard for the treatment of clubfoot, and it is in his honour that June 3rd is observed as World Clubfoot Day.</p><p>The Ponseti method involves two phases of treatment. The first phase begins with weekly serial casting, during which the deformed foot is gently manipulated into the correct position, and a plaster cast is applied from the toes to the groin. Each week, a new cast is applied after further manipulation to gradually improve the foot's position. This non-surgical treatment ideally commences within the first week of birth, although positive results can still be achieved if treatment starts within the first three months. Once the feet are corrected to a normal position, the child must wear a special shoe, known as a Foot Abduction Brace, during nighttime for 4-5 years to maintain the correction, and prevent relapse or recurrence of the deformity. After five years of maintaining corrected feet, no further intervention is typically required.</p><p>While surgery was previously a popular method for correcting clubfoot, it has proven to be less effective, often requiring multiple surgeries and failing to achieve the desired correction and functionality of the feet. Even for children who missed early treatment, the Ponseti method remains the preferred approach, with surgery considered only if the desired correction is not achieved or in cases of recurrence due to non-compliance with bracing. As children grow, it is crucial to provide appropriately sized braces to ensure that their feet remain in the corrected position during the night when human bone growth is most active. Once completely corrected, children can run, play, and actively participate in all sports and games.</p><p>In India, government medical colleges, district hospitals, and district early intervention centres have dedicated weekly clubfoot clinics, where the Ponseti method of treatment is provided. Nationally, CURE India focuses on clubfoot and operates across the country with the vision of eliminating disability from this condition.</p><p>Clubfoot might not be getting the media attention other medical conditions get, but that should not let us underestimate the scale of the challenge before us. Globally, over 200,000 children are born with clubfoot each year. In India, based on estimates from different studies and reports we have collected from the field across the country, it can be said that every day a little over 100 babies born (or about 40,000 babies per year) have clubfoot. Left untreated, clubfoot can significantly impact mobility, leading to missed educational opportunities, and access to life that a person without clubfoot enjoys. Dr Mathew Varghese, a Delhi-based orthopaedic surgeon emphasizes the importance of early intervention and comprehensive treatment to prevent disability from clubfoot.</p><p>The Rashtriya Bal Swasth Karyakram (RBSK) programme under the National Health Mission prioritises the early detection and treatment of clubfoot. ASHA workers and Anganwadi teachers are trained to identify and refer children with clubfoot for treatment, while mobile units of the RBSK reach remote areas to identify children who may have missed early intervention opportunities. The government health systems at the grassroots emphasise the importance of providing accurate information to parents in the remote villages to ensure that every child receives appropriate treatment for clubfoot, ultimately aiming for the elimination of disability caused by this condition.</p><p>On this World Clubfoot Day, let us renew our commitment to eliminate one more disability, recognise that clubfoot is a treatable condition, and advocate for comprehensive care to ensure that every child born with clubfoot has the opportunity for a healthy and active life.</p><p><em>(Santhosh G is Director, CURE India, New Delhi.)</em></p><p><em>Disclaimer: The views expressed above are the author's own. They do not necessarily reflect the views of DH.</em></p>
