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University of Iowa News Release


Sept. 14, 2007

UI, others mobilize global effort to treat clubfoot

Nearly 200 experts representing 44 countries gathered this week for the first-ever International Clubfoot Symposium, held at the University of Iowa. The meeting is part of a growing global effort that aims to promote a nonsurgical clubfoot treatment called the Ponseti method.

At the symposium, attendees issued a declaration, part of which states:

"In view of the frequency, severity, clinical implications, treatment options and public health significance, the undersigned declare that every child in the world has the right to:

-- Early and effective treatment for clubfoot.

-- Access to care, including services by a health care practitioner trained in the Ponseti method for treatment of clubfoot."

Every three minutes a child is born with clubfoot, which causes the feet to turn inward and downward. But many cases -- mostly in developing nations -- go untreated, leaving children unable to walk normally. Even children treated surgically often have less-than-ideal results.

"We want to make this nonsurgical method accessible worldwide because the treatment is low-tech and low-cost, yet results show it corrects more than 95 percent of cases, making it more effective than surgery," said conference director Jose Morcuende, M.D, Ph.D., associate professor of orthopaedics and rehabilitation at the UI Roy J. and Lucille A. Carver College of Medicine and UI Hospitals and Clinics.

Because the treatment uses simple materials (plaster casts) and can be taught in just two days to nonphysician health care providers, it can effectively deliver results in areas with few or no doctors. Nearly 80 percent of children born with clubfoot live in impoverished nations.

Representatives from the National Institutes of Health (NIH), which is helping fund the symposium, and Centers for Disease Control and Prevention (CDC) were among those supporting the initiative, which is led by Ponseti International, based at the UI.

"This meeting, which continues a tradition of leadership in clubfoot research, has been about three things: a brighter future for millions of children throughout the world, restoring and releasing human potential, and science in the service of people," said James W. Hanson, M.D., director of the Center for Developmental Biology and Perinatal Medicine at the National Institute of Child Health and Human Development, which is part of the NIH. "The NICHD, along with our partner institutes at NIH, conducts and supports research on all stages of human development, from pre-conception to adulthood, to better understand the health of children, adults, families and communities."

"We want to build on the momentum of this conference and the fact that we've already had nearly 150 workshops on the Ponseti method in 40 countries in the past several years," Morcuende said.

"Parents who have sought out the Ponseti method for their children also have made a big difference in making other families aware of this technique," Morcuende added. "We appreciate their support."

The symposium will be followed Saturday by the annual hands-on training at the UI for potential practitioners. Over the past six years, 122 individuals from 10 countries received training at the UI; however, nearly 100 people already are signed up this year's training.

The Ponseti method involves gentle, manual manipulation of the child's foot and 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.

The method is named for Ignacio Ponseti, M.D., who 50 years ago realized that surgical approaches were not successful and set about developing a better approach.

Over his career, Ponseti, now UI emeritus professor of orthopaedic surgery and rehabilitation, has treated approximately 2,000 patients at the UI. Nearly half of them have been treated in the past decade alone. At 93, Ponseti still sees patients, and colleagues and others are eager to expand his work.

"Dr. Ponseti is helping pass the baton so that Ponseti International, as an organization, can train health care providers -- and thus help children -- around the globe," Morcuende said.

The symposium is funded by the NIH (National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Child Health and Human Development, and Office of Rare Diseases), the Ponseti International Association, UI Department of Orthopaedics and Rehabilitation, the John and Ellen Buchanan Foundation, the Judge William C. Hanson Pediatric Orthopaedic Research Fund, Roger and Bridget Ryan Berman, and John and Willetta Murphy.

Collaborating organizations include the WHO, CDC National Center on Birth Defects and Developmental Disabilities, U.S. Bone and Joint Decade, American Academy of Orthopaedic Surgeons, American Academy of Pediatrics, European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America and Shriners Hospitals for Children.

The event sponsors are the UI Carver College of Medicine, UI Department of Orthopaedics and Rehabilitation, and the UI College of Public Health.

For more information, visit

STORY SOURCE: University of Iowa Health Science Relations, 5139 Westlawn, Iowa City, Iowa 52242-1178

MEDIA CONTACTS: Becky Soglin, 319-335-6660,; David Pedersen, 319-335-8032,