Treatment of Clubfoot in

Clubfoot (talipes equinovarus, TEV) is a congenital three-plane foot deformity that combines equinus (foot drop), varus (inward turn), forefoot adduction, and a high arch (cavus). It is one of the most common congenital musculoskeletal deformities, occurring in 1–3 newborns per 1000, more often in boys (2:1). The classic Ponseti method has been the global gold standard for clubfoot since the 1950s. At the Yuncheng Orthopedic Research Institute under Assoc. Prof. Liu Hejian a modified version was developed in which traditional plaster is replaced with polymer bandages. The advantages are obvious: the material does not soften when wet, the child tolerates fixation more easily, the skin suffers less, and parents can remove the bandage for bathing and hygiene — critical for infants. In our observations parental compliance with polymer bandages is markedly higher than with plaster, which directly affects outcomes. Treatment algorithm: a series of bandages at 5–7 day intervals during which the orthopedist sequentially derotates the foot (cavus → adductus → varus → equinus). Typically 4–8 stages. At the last stage a minimally invasive percutaneous Achilles tenotomy may be performed — a technique refined at the Institute over decades. After the corrective stage the child moves to a Brown brace (two special shoes on a connecting bar) that holds the feet in the corrected position. Wearing schedule: 23 hours per day for the first 3 months, then night-only until age 4. Brown brace compliance is critical: non-adherence leads to recurrence in 50%+ of cases. The ideal age to start is the first weeks of life, preferably before 1 month. The earlier — the higher tissue plasticity and the faster correction is achieved. We also accept older children — for them the program is longer and more complex but still highly effective.