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Globally, approximately 200,000 infants are born with clubfoot each year, many of them in developing nations where healthcare infrastructure and access is often limited. When left untreated, clubfoot can lead to life-long crippling disabilities, social ostracism, and poverty. Now, however, new hope is on the horizon.

AAOS Now

Published 6/1/2012
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Lynne Dowling

Expanding Access, Training for Clubfoot Treatment

AAOS and PIA collaborate on worldwide effort

Introduced more than 50 years ago at the University of Iowa by the late Ignacio V. Ponseti, MD, the Ponseti Method for the nonsurgical treatment of congenital clubfoot is simple, efficacious, and highly cost effective. It involves a series of physical manipulations and casting, followed by bracing, to permanently reverse the deformity.


(Left to right) AAOS Fellow Jose A. Morcuende, MD; Augustine Chiewolo, a physician assistant from Liberia; and Dr. Andre Georges Nguene Nyemb, Cameroon.

Global training initiative
Fueled by the passion and commitment of Dr. Ponseti, the Ponseti International Association (PIA) has created the blueprint for a program that will lead to worldwide training and treatment with the Ponseti Method. PIA’s goal is to have 4,000 healthcare providers trained in the Ponseti Method in the next 10 years—enough to treat each of the 200,000 children born annually with clubfoot.

The global training initiative involves bringing healthcare providers from 20 nations to the University of Iowa Children’s Hospital to receive training in the Ponseti Method. In addition, PIA will also expand in-country training programs in a number of countries including Brazil, Pakistan, Nigeria, India, and the Philippines, with more to be secured in the coming months. These training opportunities, both in the United States and abroad, are made available at little to no cost to the participating healthcare providers. These providers include non-physicians as well as a core group of orthopaedic surgeons. As a result, the Ponseti technique and treatment will be easily accessible, even in populous nations with a paucity of trained physicians.

AAOS lends support
AAOS is proud to support PIA in these endeavors and is working directly with the PIA board of directors and staff to raise awareness and promote participation in the offered courses. AAOS is also helping to connect PIA with orthopaedic leaders in more than 80 nations, to identify local Ponseti training sites and/or commitments for the establishment of Clubfoot Treatment Clinics, and to solicit participation in the 2012 International Club Foot Symposium, Oct. 3-5, in Iowa.

If you would like more information about the symposium, Ponseti scholarship opportunities, or if you know of a colleague in a developing nation who may be interested in Ponseti training and/or establishing a Ponseti Treatment Clinic, visit www.ponseti.info

Lynne Dowling is director of the AAOS international department. She can be reached at dowling@aaos.org