These are strict instructions to the doctors and other healthcare professionals involved in the treatment of clubfoot especially to those who apply plaster casting to correct clubfoot. If any of the commandments are ignored the Ponseti practitioners are committing, ‘common mistakes in Ponseti method of treatment for children born with clubfoot’.
- Thou shall assess and score every child during every visit using the Pirani Score.
- Thou shall perform tenotomy in 90 - 95% of children.
- Thou shall be gentle in correction and maintain the average number of casts to less than eight.
- “Thou shall not pronate” but only supinate so that the cavus is corrected before correcting the adductus.
- Thou shall not touch the calcaneus (fulcrum to be talar head always) and varus gets corrected automatically with the correction of cavus by supination and adductus by abduction.
- Thou shall not correct equines by manipulation and casting. Equines has to be corrected only by tenotomy. If the equines is corrected by forceful manipulation and casting, the foot will go rocker-bottom shape.
- Thou shall not ignore the child after casting and tenotomy. Parents should be guided to follow up for five years of bracing to prevent relapse.
