Clubfoot

PONSETI METHOD IN LITHUANIA AND RUSSIA

Two years ago in Lithuania with almost 60 cases of congenital clubfoot per year, we had almost the same situation as in Russia today. Many things have changed when our son Jacob was born with right clubfoot.

After the successful Ponseti treatment in Hamburg with the help of prof. Ponseti and doctor M.F. Sinclair we decided to organize a Ponseti seminar in Lithuania. Fortunately, we were able to gather leading orthopedic doctors interested in the method and finally had a seminar “Clubfoot treatment using Ponseti method” in July, 2004.

Now in Lithuania we have at least two official Ponseti doctors and this method is often mentioned in the magazines for parents. There is also a fully established Denis Browne Bar production in two of the Lithuanian orthopedic factories. This production has just started, but the parents don’t have to pay for the braces because these braces are covered by insurance.

There are around 1300 cases of congenital clubfoot diagnosed in Russia as compared to around 400 cases found in Ukraine every year.

Many sources on the Russian Internet suggest that congenital clubfoot is usually treated there using conventional casting. This treatment often leads to many unnecessary feet surgeries.

There are quite many stories about long – term casting which fails to correct clubfoot. The babies usually have clubfoot surgeries when they are 6 months old.

Some active parents are trying to seek for any information concerning congenital clubfoot on the Internet. The only source to get some advice are Russian Internet websites for parents. It is quite obvious from the parents’ internet messages I have read that the parents often have to guess about their child's diagnosis. It is not very common in Russian speaking countries to question the treatment prescribed by the doctor as it is considered very impolite. The parents usually never ask neither about the diagnosis nor the treatment. Because of this reason, the majority of doctors don‘t even bother explaining the methods of treatment used. Moreover, they seldom speak about the possible bad consequences of the clubfoot surgery. In general, there is no information about clubfoot treatment methods other than conventional casting, physiotherapy or massage on the Russian Internet.
Searching the Russian Internet websites I have discovered that about 80% of the clubfoot questions asked by the clubfoot parents are answered by other parents rather than orthopedic doctors or medical specialists. This has created a quite common opinion and misunderstanding among the parents that congenital clubfoot can be cured by just wearing odd shoes or after a couple of massage sessions performed by the parents themselves. This situation leads to other stories about children who cannot walk normally because of the neglected or incorrectly treated clubfoot.

The situation in Russia and Ukraine could change in the future if understanding of English language increased. At present time there are quite few people in these countries who are able to search the web in English language. Therefore, they have no access to an objective medical information and Ponseti method. The only clubfoot parents who have access to the Internet are those living in the biggest towns.

One step to break the language barrier was the translation of “Ponseti book” into Russian language on www.global-help.org We hope that our Lithuanian clubfoot website and especially the Russian part of it will help to spread Ponseti method in the Russian speaking countries.