Effectiveness of the ponseti method in treating neurogenic clubfoot: a systematic review and meta-analysis

作者：Xiaofeng Shan, J L Fu, Weiming Hu, Feipeng Wang, Fuyun Liu, Bing Xia · 发表于：Journal of Orthopaedic Surgery and Research · 年份：2025 · DOI：10.1186/s13018-025-06492-7 · 被引用次数：3 · 研究领域：Foot and Ankle Surgery、Lower Extremity Biomechanics and Pathologies、Botulinum Toxin and Related Neurological Disorders

Abstract Background The outcomes of the Ponseti method in neurogenic clubfoot remain uncertain due to deformity rigidity and high relapse risk. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of Ponseti treatment in pediatric neurogenic clubfoot. Methods Following PRISMA 2020 guidelines, we searched PubMed, Embase, Cochrane Library, Web of Science, and Scopus through May 2025. Eligible studies reported Ponseti outcomes in pediatric neurogenic clubfoot. Two reviewers independently assessed study quality using the Newcastle–Ottawa Scale. Random-effects meta-analyses were performed using R software (version 4.5.1) with the meta package in RStudio. Heterogeneity was assessed using I 2 statistics, and publication bias was evaluated using funnel plots and Egger test. Results Thirteen studies comprising 214 patients with 336 feet and mean follow-up of 3.6 years [range 2.0–12.0] were analyzed. Initial correction was achieved in 90% of cases (95% CI 86–93%), while long-term success declined to 77% (95% CI 53–90%). Recurrence occurred in 52% (95% CI 37–66%), and complications in 28% (95% CI 13–50%). Mean cast number was 5.88, with Achilles tenotomy required in 87% (95%CI 70–95%). Subgroup analysis revealed excellent homogeneity in myelomeningocele patients (I 2 = 0%) with 87% success rate. Conclusions The Ponseti method demonstrates significant efficacy in neurogenic clubfoot management, achieving initial correction in approximately 90% of cases. Howe...