Ignacio Ponseti
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Ignacio Ponseti (3 June 1914 – 18 October 2009) was a physician, specializing in orthopedics. A native of Spain, he fled the Spanish Civil War and became a faculty member and practicing physician at the University of Iowa.
He developed in the 1950s the Ponseti Method (also known as the Ponseti Technique), a non-surgical technique that uses a series of casts, followed by a brace, to correct congenital clubfoot. The condition causes a baby's feet to turn inward and downward; if not corrected, a child is unable to walk or move properly.
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Biography
Known for the method for the clubfoot treatment that bears his name, Ignacio Ponseti was Professor Emeritus in the Department of Orthopaedic Surgery at University of Iowa Hospitals and Clinics.
Born 3 June 1914 in Menorca, part of the Balearic Islands, Spain, Ponseti was the son of a watchmaker and helped repair watches. The skill was said to eventually contribute to his abilities as an orthopedist.[1]
Ponseti studied medicine at Barcelona University. Not long after he graduated, fighting broke out between Francisco Franco Bahamonde’s forces and the Spanish Loyalist army—the start of the Spanish Civil War. Ponseti served as a medical officer with the Loyalists as a lieutenant, then captain, in the Orthopaedic and Fracture Service. His duties included setting fractures, which put him on a career in orthopaedics. Without ambulances, Ponseti used the help of local smugglers to take the injured into France.[1] He soon escaped to France himself and went to Mexico, where for two years he practiced family medicine. A physician there helped Ponseti get to Iowa in 1941 to study orthopaedics under Arthur Steindler, M.D. Ponseti completed a residency at Iowa in 1944 and became a member of the orthopaedic faculty at University of Iowa Hospitals and Clinics.
Early in his career at Iowa, Ponseti saw that the outcomes of clubfoot surgical treatments were not very good—patients had limited movement. He set out to develop a treatment that made the most of babies' flexible ligaments.[2] The method was met with some opposition but over the past 50 years it has been adopted by many doctors and other health care providers worldwide, including in Britain [3] and Turkey [4]
Well into his nineties, Ponseti continued to see patients and trained visiting doctors from around the world. He also developed new prosthetic devices with John Mitchell of MD Orthotics [1] and produced training and information DVD's on the method.
Ponseti's other research focused on congenital and developmental bone and joint disorders, skeletal growth disorders in children, and the biochemistry of cartilage. He gained insight in the early 1950s on the effect of amino nitriles on collagen cross linking, defined the curvature patterns of idiopathic scoliosis, and demonstrated that curves progressed after skeletal maturity. He also conducted many studies evaluating the long-range results of treatments for congenital dislocation of the hip, clubfoot and scoliosis.
The Ponseti Method
Clubfoot affects well over 100,000 newborns annually.[5] Early in his career at the University of Iowa, Ponseti realized that surgical approaches did not fully correct clubfoot and/or created problems later in life, such as severe arthritis or even requiring more surgery.[2] In working to develop a new approach, he determined it could be nonsurgical. The Ponseti method uses gentle, manual manipulation of the foot, followed by application of toe-to-groin plaster casts. The casts are changed weekly after a clinician manipulates softened foot ligaments to gradually achieve near-normal muscle and bone alignment.
In addition to the improved physical outcomes, compared to surgery, the Ponseti method is less expensive and can be taught to nonphysician health care providers, which is useful in areas with few or no doctors. Nearly 80 percent of children born with clubfoot live in impoverished nations. The Ponseti method is used, for example, in Uganda, where efforts continue to improve the availability of the treatment.[6]
Information about the use of Ponseti method can be found at these sites: World Health Organisation, American Academy of Orthopedic Surgeons, Pediatric Orthopaedic Society of North America, STEPS Charity UK and STEPS Charity South Africa.
At the 2007 International Clubfoot Symposium attended by 200 doctors from 44 countries, papers were presented regarding an estimated 10,000 children successfully treated with the technique around the world in the past few years.
The Ponseti International Association for the Advancement of Clubfoot Treatment was founded in 2006 to improve the treatment of children born with clubfoot through education, research and improved access to care. PIA has a related Web site devoted to the interests and needs of parents[7]. Groups that work with Ponseti International include Cure International and A Leg to Stand On (India).
Notes
References
- ^ a b Wilcox, Carol (February 2003). "A healing touch". Iowa Alumni Magazine. Retrieved 2007-12-26.
- ^ a b McKee, Jennie (2007). "Ponseti method revolutionizes clubfoot care". Bulletin of the American Academy of Orthopedic Surgeons (AAOS Now). 1 (10).
{{cite journal}}: Unknown parameter|month=ignored (help) - ^ Cosma D, Vasilescu D, Vasilescu D, Valeanu M (2007). "Comparative results of the conservative treatment in clubfoot by two different protocols". J Pediatr Orthop B. 16 (5): 317–21. doi:10.1097/BPB.0b013e32826d18a6. PMID 17762669.
{{cite journal}}: Unknown parameter|month=ignored (help)CS1 maint: multiple names: authors list (link) - ^ Göksan SB (2002). "[Treatment of congenital clubfoot with the Ponseti method]". Acta Orthop Traumatol Turc (in Turkish). 36 (4): 281–7. PMID 12510061.
- ^ World Health Organization: http://www.who.int/mediacentre/news/notes/2007/np30/en/index.html Retrieved on 2007-12-26
- ^ McElroy T, Konde-Lule J, Neema S, Gitta S (2007). "Understanding the barriers to clubfoot treatment adherence in Uganda: a rapid ethnographic study". Disabil Rehabil. 29 (11–12): 845–55. doi:10.1080/09638280701240102. PMID 17577719.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ "Clubfoot Information for Parents". Ponseti International for the Treatment of Clubfoot Website for Parents. Ponseti International Association. 2009. Retrieved 2009-03-13.
- Percas-Ponseti, Helena (2007). Homage to Iowa: The Inside Story of Ignacio V. Ponseti. University of Iowa Press.
- Ponseti, Ignacio (1996). Congenital Clubfoot: Fundamentals of Treatment. Oxford, Oxfordshire: Oxford University Press. ISBN 0-19-262765-1.