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Children's Physiotherapy -
Clubfoot and Ponseti treatment
The Ponseti service offers the full assessment and treatment of children with structural foot deformities. This includes conditions such as Clubfoot (Congenital Talipes Equinovarus), Congenital Vertical Talus and Metatarsus Adductus as well as other foot deformities.
Our clinic was established in 2005 and includes a team of Consultant Paediatric Orthopaedic Surgeons and Specialist Physiotherapists.
The Ponseti Method
The service follows the Ponseti method as the primary management for Clubfoot. The aim of the treatment is for the child to have a pain free and flexible foot, and to be able to wear normal footwear.
Antenatal counselling is offered following diagnosis at the 20-week scan. The clinic runs weekly, with treatment usually starting two to three weeks following delivery. The casting phase is a series of weekly casts above the knee to gently manipulate and correct the foot position.
The child may require an Achilles tenotomy which is often performed under local anaesthetic in clinic. Following this, three further weeks of casting is required, then transition into a Foot Abduction Brace. The brace is worn for 23 hours a day for 12 weeks, then at night and nap times until the child is age 5.
The Ponseti Team
- Olga Bizby, Specialist Paediatric Physiotherapist
- Natalie Morgan, Specialist Paediatric Physiotherapist
- Amelia Stubbs, Paediatric Physiotherapist
- Clare Carpenter, Consultant Orthopaedic Surgeon
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Key contacts
For referrals and appointments: Paediatric Orthopaedic Secretaries
Contact: 02920 748034
For clinical questions: Email ponseti.cav@wales.nhs.uk
Request for assistance
The Plaster room is open Monday-Friday from 8.15am-4pm. You can contact the service for advice via Physiotherapy on 02921 847577 or the Plaster room on 02921 847991.
Out of hours
Outside of the above timeframes, Ponseti plaster casts can be removed if:
- the foot has slipped inside the cast
- if circulation is compromised
- in case of medical emergency
Casts will be re-applied non-urgently. Parents should contact us on the first working day after removal.
Cast slips
It is a good idea to take a picture of the child’s toes when the plaster is initially put on. A child’s toes should be regularly checked to ensure that the cast has not slipped, we advise every nappy change. Signs of a slip would include the toes pulling inside the plaster. If you notice a cast slip, please contact the service as soon as possible as the cast will need to be changed.
Post tenotomy
If the baby has had a tenotomy (cutting of the Achilles tendon), there can be bleeding afterwards. We try to minimise the likelihood of this. The area of blood should be no bigger than a 2p coin.
If concerned, please contact the department via Physiotherapy on 02921 847577 or the Plaster room on 02921 847991.
