Introduction: Though numerous studies have assessed the function of idiopathic clubfeet (CF) treated by the Ponseti method, few studies have assessed alterations in the unaffected foot of patients with unilateral CF imparted by Ponseti bracing. The purpose of this study was to identify pedobarographic differences in the unaffected foot of patients with unilateral CF treated with the Ponseti abduction brace and to determine if those differences persist over time. Methods: Patients with unilateral CF who were treated during infancy by either the Ponseti method or the French Physiotherapy method (PT) were prospectively followed until the age of 16 years. Following correction, those treated by the Ponseti method used an abduction brace 23 hours a day for 3 months, followed by nighttime brace wear until at least 2 years of age (Braced). Those treated with the PT method had a custom unilateral orthosis fitted only to the affected foot during the maintenance phase of treatment (Unbraced). Pedobarographic assessment of the unaffected foot was collected longitudinally at 2, 5, 10, and 16 years of age. Nonparametric Mann-Whitney U tests were used to compare plantar contact area (CA%), mean force (MF%), and contact time (CT%) between groups. Results: Forty-three patients (18 Braced and 25 Unbraced) underwent pedobarographic assessment at all time intervals. Braced patients demonstrated significantly higher MF% and CT% in the medial and lateral midfoot at 2 years of age. These differences, however, were resolved by age 5, with no difference in plantar pressures between groups at 16 years or younger. Discussion: Abduction bracing of the unaffected foot in patients with unilateral CF deformity results in measurable increases in midfoot MF% and CT% during the brace phase of treatment. This indicates that bracing does impart an increased pes planus posture of the unaffected foot; however, these changes are transient and are expected to resolve after brace discontinuation. This information should reassure parents of unilateral CF patients concerned about the effects of abduction bracing on the unaffected foot. Level of Evidence: Therapeutic Level II.
Jeans et al. (2026) studied this question.