Pearls and Pitfalls of Ponseti Method Bracing for Idiopathic Clubfoot—An Institutional Guide to Optimize Orthotic Management

This review explores key insights and challenges in the bracing phase of the Ponseti method, integrating institutional experience to offer practical strategies for optimizing the management of idiopathic clubfoot. While the Ponseti method is the gold standard for clubfoot correction, it is not without challenges and complications. Successful treatment relies on a collaborative effort between healthcare providers and caregivers. It requires both effective correction by the provider and consistent adherence to the bracing protocol by the caregiver. The purpose of this review is to identify common challenges encountered during the bracing phase and highlight effective strategies for achieving successful outcomes. Grounded in institutional experience, this review offers practical, actionable recommendations that providers and orthotists may implement to better support patients and their caregivers throughout the treatment process. Key Concepts: (1) The bracing phase of the Ponseti treatment method is essential for maintaining initial correction. (2) Brace intolerance is the greatest predictor of clubfoot relapse, surpassing even the initial severity of the deformity. (3) In our experience, proactive cultivation of confidence and clarity in caregivers as they navigate the bracing process is critical to maintaining brace tolerance. (4) Our institution’s approach to Ponseti method brace fitting and management consists of various practical modifications to reduce the likelihood of skin abrasion and irritation.