Effectiveness of the ponseti method in treating neurogenic clubfoot: a systematic review and meta-analysis
Bibliographic record
Abstract
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. However, the elevated recurrence rate of 52% necessitates structured long-term surveillance and timely interventions to maintain correction. Given inherent sensory impairments in this population, vigilant monitoring for cutaneous complications is essential. These findings support the Ponseti method as the preferred initial treatment approach for neurogenic clubfoot. Trial registration PROSPERO CRD420251060145.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.036 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".