Evolution of treatment methods for idiopathic clubfoot and comparative evaluation of the effectiveness of the modified Ponseti protocol

Idiopathic congenital clubfoot is one of the most common orthopedic deformities in newborns. Despite the Ponseti method being widely recognized as the gold standard for treatment, the issue of relapse remains relevant, particularly in severe and atypical cases.The aim of this study is to analyze the historical evolution of treatment approaches for clubfoot and to evaluate the effectiveness of the classical and modified Ponseti protocols based on clinical experience.Methods. A retrospective analysis was conducted on data from 100 patients with congenital clubfoot treated at the Kinetic Medical Center between 2021 and 2024. The patients were divided into two groups: the control group (n=59), which received treatment according to the classical Ponseti protocol, and the main group (n=41), which was treated using the modified protocol. All patients were evaluated using the Pirani scoring system, with further analysis of relapse rates, the number of casting stages, and the nature of the deformity.The results showed that the modified protocol provided more reliable correction in atypical forms and severe degrees of typical clubfoot, reducing the relapse rate from 12.3% to 7.3%. The inclusion of an additional casting stage and a differentiated fixation technique contributed to improved functional outcomes and increased patient compliance.Conclusions. The data obtained confirm the rationale for individualizing the Ponseti protocol in complex clinical cases. The modified approach demonstrates potential for improving long-term outcomes in the treatment of congenital clubfoot.Keywords:clubfoot, Ponseti method, modified protocol, relapses, Pirani score, orthopedics.