An aging orthopaedic specialist and a group of enthusiastic parents have jointly begun to change the orthopaedic establishment’s view of how best to treat children born with clubfoot.

This remarkable turnaround, affecting children and parents in more than two dozen countries, was achieved in a few short years. It was made possible by the power of the Internet along with the dogged persistence of 90-year-old Ignacio Ponseti, M.D.

Ponseti—who greatly advanced his orthopaedic skills while treating hundreds of wounded soldiers in the Spanish Civil War—came to University of Iowa Hospitals and Clinics in 1941. Most of his illustrious orthopaedic career has been spent here, and he still sees patients in a clubfoot clinic bearing his name.

In the early days of his Iowa career, some five decades ago, Ponseti developed a relatively simple alternative nonsurgical method of treating babies with clubfoot. Even though this “Ponseti Method” was shown to be successful in Iowa and was documented in a book written by Ponseti, most babies born elsewhere with the deformity were treated with surgery. Only a handful of the world’s orthopaedic surgeons (among them three orthopaedic colleagues at University of Iowa Children's Hospital, located at UI Hospitals and Clinics) used his nonsurgical method.

In recent years a few influential orthopaedic specialists at other major academic medical centers began to recognize that Ponseti’s outcomes were superior to surgical ones. As well, a growing number of loyal, grateful parents began using the Internet clubfoot message boards to educate thousands of other parents about the method.

The impact of these events has been impressive. More parents became aware of his method and asked their physicians about it. Within the profession, a major breakthrough occurred when Ponseti was invited to make high-profile presentations at two national orthopaedic conventions, appearances that helped convince many colleagues that past surgical approaches had produced less satisfactory long-term results.

“It’s pretty remarkable,” Ponseti says of the growing interest in his method. “I’m grateful to the parents who are helping encourage this change, and very excited by the positive impact it will have on future generations.”

Ponseti’s worldwide reach

Nations where at least some physicians are practicing the Ponseti Method: Argentina, Australia, Belgium, Brazil, Bulgaria, Burundi, Canada, Chile, Ecuador, England, France, India, Israel, Italy, Kenya, Malawi, Mexico, New Zealand, Spain, Sweden, Switzerland, Scotland, Tanzania, Thailand, Uganda, United States, Uruguay.

Graham Sandersfeld of Middle Amana, Iowa, is one of hundreds of children who, as babies born with clubfoot, received successful treatment from Ignacio Ponseti, M.D., at University of Iowa Children's Hospital.

“Many colleagues who used to doubt the technique now realize it is best and that traditional surgery has not produced the best possible long-term outcomes for these kids.”

—Ignacio Ponseti, M.D.