  Clubfoot is one of the most common congenital deformities. It occurs in about 1 out of every 1000 births. It affects males more commonly than females. The cause in an otherwise healthy child is unknown. It can affect one or both feet. The foot shape at birth is pointed inward and downward giving the foot a “club” appearance. In many institutions, manipulation and casting technique is used with frequent unsuccessful correction. As a result, extensive corrective surgery is then recommended with often disturbing poor results due to excessive scarring.
The Ponseti treatment method
Dr. David uses the Ponseti Method of serial casting of the foot and leg. This treatment has become the standard of care nationwide. Treatment should begin within 1 to 2 weeks after birth. The foot is gently manipulated and plaster casts are applied and changed weekly for 3-6 weeks in the office without anesthesia. Correction can be achieved in over 90 % of the cases without the need for extensive surgery. Occasionally a release of the heel cord is needed. This is performed in the office through a tiny incision without the need for anesthesia or hospitalization.
Relapses are uncommon, and are corrected successfully in most cases with 1-3 more casts. Special shoes attached to a bar are used 20 to 22 hours per day for 3 months, followed by during sleep hours use for 2 to 4 years. Dr. David has frequently used this treatment successfully in older children who have had failed treatment from other institutions.
Dr. David has traveled to the University of Iowa on many occasions to receive training directly from Dr. Ponseti. He is the only physician in West Michigan who is certified by Dr. Ponseti and the University of Iowa referral website. He has given many educational presentations on this topic and has been featured in the Grand Rapids Press.
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