Ignacio V. Ponseti: Creator of the Ponseti Method for Treating Clubfoot in Children
Dr. Ponseti Dies of a Stroke
Dr. Ignacio V. Ponseti was a brilliant man with a gentle soul. He worked over 50 years to research, implement and teach others the Ponseti Method, his non-surgical method of treating clubfoot in children. Ignacio Ponseti died suddenly Sunday, October 18, 2009 at the age of 95 at the University of Iowa Hospitals and Clinics. He was at work just a few days earlier in his university office.
Ponseti was born June 3,1914 on the Spanish island of Minorca. He worked summers in his father’s watch repair business where he learned the skills of precision and patience. Both became essential for his chosen career.
He entered medical school in Barcelona in 1930 and completed his degree in 1936. He then volunteered to serve as a medic in the Loyalist Army in the Spanish Civil War. He worked in the Orthopaedic and Fracture Service treating battle wounds. In 1939 when the Fascist Army gained control he fled the country before he could be imprisoned. He fled into France but did not stay long. A war with Germany was looming on the horizon. The French wanted all of the Spanish refugee doctors to join the French Army. But when they refused to give them French citizenship, Ponseti travelled to Mexico when their president welcomed them with open arms. He was the doctor for a small town south of Mexico City. In Mexico City he met a professor who had trained in the US and with his help he met with Dr. Arthur Steindler, chairman of Orthopaedics at the University of Iowa. He moved to Iowa City, Iowa in 1941. He completed his residency in 1944 and then joined the faculty at the University of Iowa Hospitals and Clinics. He worked tirelessly for four decades treating patients, teaching and researching. He was forced to retire in 1984 at the age of 70 which was the university’s mandatory retirement age. In 1986 that requirement was lifted and he returned and worked until his life ended.
He started work on his non-surgical method of treating clubfoot in the 1940’s. The traditional surgical treatment resulted in stiff, fixed ankles. Though the children could walk, they almost always had a limp. They also developed arthritis and suffered a lot of pain later on in life. Ponseti’s technique involved physical manipulation of the joints, muscles, ligaments, and tendons in the child’s foot and then it was put in a plaster cast that extended from toe to upper thigh. This cast was worn for 4 or 5 days. During the gentle manipulations Ponseti played Mozart music to soothe the babies. Many even fell asleep. After 4 or 5 more of these manipulations and castings, the clubfoot was corrected. To prevent a relapse, they needed to wear shoes that are attached to each end of a bar for 3 months. After that, only at night and during naps for 3-4 years. From then on, there was rarely a relapse. His method is 95-98% effective, inexpensive and nurses and medical assistants can be trained to perform the procedures. This is especially helpful in underdeveloped countries that are short of doctors.
Dr. Ponseti's Book
The first 40 years, his method was not widely used or even accepted. Many did not believe it worked. Ponseti did not push the issue because he wanted to make sure the manipulations were lasting. Finally in 1996 he wrote a book entitled Congenital Clubfoot: Fundamentals of Treatment. The book, combined with peer reviews and a grass-roots movement on the internet by parents of his patients, helped spread the word. It is only in the last decade that his method has become the preferred method. In 2006 the Ponseti International Association for the Advancement of Clubfoot Treatment was founded. It is devoted to education, research and improved access of care including helping health care professionals learn about and use the method. By the 2000’s, Dr. Ponseti had patients from 5 continents and visits from doctors from all over the world wanting to learn his technique so they could teach others in their countries. Orthopaedic surgeons from all around the states and abroad came to Iowa City almost every week to observe and learn. Uganda in Africa was the first country outside the US to adopt the Ponseti Method. Clubfoot was especially common in their country.
Ponseti’s association sponsors annual races for the kids who were his patients. They have also added an adult 5K race/walk to help raise money and awareness. The most recent one was Oct 16, two days before he passed away. He was in the hospital on race day but his wife Helena was there in his place to welcome all the kids. The PIA has pledged to honor his memory by continuing to promote his method.
An Extraordinary Doctor
Dr. Ignacio Ponseti will always be remembered for his hard work, his mild manner and his love of children. His work will continue to help hundreds of thousands of children around the world.
Homage to Iowa: The Inside Story of Ignacio V. Ponseti
written by his wife, Helena Percas-Ponseti
Various news stories and the press release from the University of Iowa