Relapse and Long Term Outcome
Talipes is never ‘cured’, rather the position and function of the feet are maximised by the treatment. Sometimes, clubfoot can reoccur. This is known as a relapse and it is estimated to occur in 1 or 2 out of every 10 cases. Relapses are more likely if the Ponseti method is not followed exactly.
When there has been a relapse, it may be necessary for some of the treatment stages to be repeated – for example, your child may need to have their foot manipulated again and put in a cast.
In some cases, ensuring that your child continues to wear the boots and bar may be enough to improve their clubfoot significantly. However, in other cases where there has been a relapse, surgery may be required.
Continuing with the boots and bar up to the age of 4/5 years reduces the incidence of a relapse to 5% (there is a 30% risk of relapse if stopped at 3 years of age). The distance between the shoes should be shoulder width and the boots should be properly fitted to accommodate growth, both length and width. The boots will need to be changed as your baby’s feet grow in size.
What is the long term outcome?
Most children do very well with treatment and there will be no problems going to school and taking part in a full range of sporting activities. There has only been one long term study following children through to adulthood and this was specifically to look at the results of the Ponseti method. This study showed that the use of this method resulted in no greater severity of foot pain in mid life to those experienced by people not affected by club foot.
Following treatment, the specialist will probably monitor your child until their feet have stopped growing.