Clubfoot Treatment and Education
 Through our orthopedic surgical work in Vietnam, we have become keenly aware of a great number of children and adults who have been crippled by neglected clubfoot. If properly managed soon after birth, clubfoot can be easily and affordably corrected before a child learns to walk. Through demonstration projects in Son La and Ha Tay Provinces, POF has begun exploring the feasibility of introducing the Ponseti Method of clubfoot treatment to rural areas in northern Vietnam.
What is clubfoot and why is it a problem in Vietnam?
Clubfoot, talipes equinovarus, is a congenital condition, present at birth, causing the foot to bend progressively inward and downward as the child grows.
Clubfoot occurs in 1-3 babies out of every 1000 born worldwide.
If left untreated, clubfoot causes severe deformity in one or both feet resulting in painfully crippling, lifelong disability.
In developing countries, clubfoot is the single most common congenital cause of physical disability. In the US, clubfoot is rarely visible because children born with this condition are treated promptly after birth, preventing disability.
To date, most healthcare professionals in northern Vietnam are not providing early intervention clubfoot treatment.
In rural Vietnam, babies born with clubfoot are typically not identified because maternity nurses have not been trained to recognize the condition and are not aware of treatment options.
In 2006, approximately 1/3 the surgeries funded by POF were for neglected clubfoot cases.
What can be done about clubfoot?
The Ponseti Method is a non-surgical, early intervention treatment method pioneered in the 1950s by Dr. Ignacio Ponseti, a surgeon at the Univ. of Iowa.
The method involves manual manipulations of the foot combined with serial castings while the child is still an infant and the tissues and ligaments are still pliable. The casting phase is followed by a shoe-brace protocol which maintains the correction during critical years of growth.
When executed correctly, the Ponseti Method has a 94% success rate. Typically, the treated foot/feet look and function normally into adulthood.
Ponseti is a low-cost, low-tech, and internationally accepted protocol, ideally suited to implementation in developing countries. It has been used successfully during a 4-year pilot project in Uganda and is currently being implemented in other developing countries worldwide.
What POF is doing to treat clubfoot in Vietnam?
The implementation of our demonstration projects in Son La and Ha Tay consist of four main activities:
Training doctors from Son La Provincial Hospital and Ha Tay Orthopedic Technical Rehabilitation Center (OTRC) in the Ponseti treatment method.
Doctors involved in the POF clubfoot project have taken initial short courses on the Ponseti method from Viet Cot and have received additional training from the Danang Orthopedic Center.
 Training maternity hospital staff and nurses throughout Son La and Ha Tay in recognizing and referring clubfoot cases.
The goal of the seminars is to introduce district and commune level clinic staff to the clubfoot project, show them how to recognize clubfoot, and instruct them on how to refer patients to the appropriate hospitals.
Along with the seminar content (presented by Ponseti-trained doctors), each nurse receives printed reference materials, posters for the local clinics, and educational brochures to give to parents in their communes.
Educating parents about clubfoot treatment and their important role in ensuring its success.
In addition to the educational materials that are distributed to parents by the seminar-trained nurses, POF is cooperating with other local networks to help distribute posters, brochures, and other educational materials.
Developing locally-fabricated Foot Abduction Braces (the corrective shoes worn by babies after they finish the casting sequence).
In partnership with the Ha Tay OTRC workshop, prototype shoe braces have been developed and are being used by both demonstration sites.
Learn more about POF-sponsored clubfoot treatment...
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