Ponseti Casting

The Ponseti method is the internationally recognised gold standard for treating congenital clubfoot (talipes equinovarus) in newborns, developed by the American orthopaedist Ignacio Ponseti in the mid-20th century. The approach is non-surgical and consists of three sequential phases. First — casting: a series of 5–7 above-knee plaster casts, each fixing the achieved correction of the foot's position. Casts are changed weekly, gradually shifting the angle. Second — Achilles tenotomy: a minimally invasive percutaneous release of the Achilles tendon to correct the equinus component. Performed under local anaesthesia, it takes a few minutes. Third — orthotic retention with the Denis Browne brace (foot abduction shoes on a bar): worn 23 hours a day for the first three months, then only at night until age 4–5 to prevent relapse. At our Huizhou centre Ponseti casting is led by the orthopaedic team under Professor Liu Hejian (刘合建), founder of Hejian Foot & Ankle. The method is integrated with OT and PT to embed the corrected foot into the child's daily motor patterns.