2025 SICOT Annual Meeting: Is It Better To Start Ponseti Method For The TreatmentOf Congenital Idiopathic Clubfoot In The First 4 Weeks OfLife?

Six studies involving 467 infants (689 feet) with idiopathic clubfoot were included in this systematic review and meta-analysis comparing Ponseti treatment initiated before 4 weeks versus after 4 weeks of age. Pooled outcomes of interest included number of casts, need for tenotomy, and recurrence rates. Results showed that starting treatment earlier (<4 weeks) was associated with a slightly higher number of casts (MD: 0.72, 95% CI [0.33, 1.10], p = 0.0002), but there were no significant differences in overall mean casts (p = 0.91), tenotomy rates, or recurrence rates between groups. The findings suggest that initiating treatment earlier does not necessarily improve long-term outcomes and delaying until after 4 weeks may be reasonable.