Mary Snyder found out at her 19-week ultrasound that her unborn baby had clubfoot. Both of the fetus’s feet were completely turned inward, forming the twisted U-shape typical of clubfoot.
The condition is one of the most common birth defects, affecting about 1 out of every 1,000 babies, but that was little comfort to Snyder.
“It was terrifying,” remembers Snyder, who lives in Towson, Md. “It was very emotional. We did a lot of testing and everything to make sure she was going to be OK, but you never really know until you see them when they’re born.”
Just a decade ago, up to 90 percent of babies like Snyder’s daughter Alice were treated with surgery that usually had to be repeated several times. That created a buildup of scar tissue that often left patients with a lifetime of chronic pain, stiffness, arthritis and medical bills. But with the help of a simple, noninvasive solution and an Internet campaign led by parents, the course of treatment and likely outcomes have changed completely.
Alice, who is now 6, has a checkup every year with Dr. John Herzenberg, an orthopedic surgeon at Sinai Hospital in Baltimore. Alice happily follows the doctor’s instructions, walking back and forth across the exam room, then on her tippy toes, and finally with her feet turned out like a duck.
In the past, before I learned Ponseti, guaranteed I would literally have had to do a surgical operation to take apart and put together the entire foot,” says Herzenberg, looking at a photo of Alice’s feet at birth, which formed a bowed U-shape beneath her tiny torso.
The casting technique was developed by Dr. Ignacio Ponseti at the University of Iowa in the 1950s. The Spanish physician discovered that if an infant’s feet were slowly turned out over the first few months of life, the foot could be coaxed into a normal position.
Unlike the traditional surgical method, the Ponseti method is pretty much painless, and patients who receive it usually have a complete recovery, with no long-term discomfort. It also costs less. Ponseti spent the next 50 years tirelessly trying to get other doctors to accept it, but with little success.
“People were falling over themselves to do fancy invasive surgery, and this one strange old guy who speaks softly with a Spanish accent in Iowa was getting sort of ignored by the drumbeat of people who were in favor of surgery,” says Herzenberg, who is one of the foremost practitioners of the Ponseti method today.
Surgeons are trained to operate, explains Herzenberg, and usually that’s the way they make money. The Ponseti method brings in a lot less for orthopedists. For about 50 years, the technique mostly stayed in Iowa.
But then something new came along: the Internet.
When Jennifer Trevillian’s daughter was born with clubfoot in 2000, the doctors said surgery was inevitable. “He started talking about her pending surgery before he physically examined her foot,” Trevillian remembers.
