An Analysis of the Mechanical Properties of the Ponseti Method in Clubfoot Treatment

摘要: Congenital clubfoot is a complex pediatric foot deformity, occurring in approximately 1 1000 live births and resulting significant disability, pain if left untreated. The Ponseti method of manipulation widely recognized as the gold standard treatment for congenital clubfoot; however, its mechanical aspects have not yet been fully explored. During multiple manipulation-casting cycles, tendons ligaments on medial posterior aspect ankle, which are identified rate-limiting tissues, usually undergo weekly sequential stretches, with plaster Paris cast applied after stretch to maintain length gained. This triggers extracellular matrix remodeling tissue growth, but due viscoelastic properties ligaments, initial strain size, rate, loading history will affect relaxation behavior strength tissue. To increase efficiency treatment, we discuss theoretical possibilities decreasing size step interval casting and/or increasing overall number casts. modification may provide more tensile stimuli, allow time remodeling, preserve integrity soft tissues.