Efficacy of a New Design of Foot Abduction Brace (FAB) Compared to Standard FAB During Ponseti Treatment of Idiopathic Clubfoot by Measuring Rate of Recurrence and Compliance Using Novel Touch Sensors

Clubfoot is the most common birth defect affecting 1 in every 750 live births, that is about 200,000 babies each year globally (80% mainly in developing countries). An estimated average 1 million children are currently living with untreated clubfoot. In India every 10 minutes a child is born with clubfoot i.e. over 50,000 children are born with this deformity every year (1 per 500 birth). The Ponseti Method is now recognized as the accepted standard for the medical treatment of clubfoot. The Ponseti Method is ideally suited for the developing world in that it is inexpensive, non-surgical and the casting component can be completed by trained medical and paramedical personnel. Clubfoot causes the feet of the affected individual to point downward and inward. Left untreated, clubfoot causes a permanent physical disability, preventing the individual from walking normally and limiting his or her mobility. Decreased ambulation can lead to the inability to perform daily tasks, such as going to school, leading to increased dependency and a negative economic impact on the family. Furthermore, deformity caused by neglected clubfoot can lead to limited social integration and stigma for both the individual and the family.

The gold standard of clubfoot treatment is the Ponseti method, which consists of 6-8 weeks of serial castings followed by a percutaneous Tendo Achilles tenotomy in the majority of cases. The casting is followed by the use of a foot abduction brace (FAB) for approximately 4 years. The goal of the treatment is to correct the deformity so that the patient has a functional, painless, plantigrade foot with full mobility without the need for orthotics. The 6-8 weeks of serial casting corrects the clubfoot deformity while the use of the FAB after casting prevents the deformity from reoccurring and is required for successful treatment. Noncompliance of FAB use increases the risk of relapse 17-fold.

Currently, the Steenbeek Foot Abduction Brace (SFAB), a version of the Denis Browne splint, is the only low-cost FAB available. The SFAB is made by hand by artisans, limiting its large-scale production. Furthermore, it can be challenging to put on a child due to the shoes being attached to the bar and lacking a strap in addition to laces, potentially leading to noncompliance.

The more recently developed MiracleFeet Foot Abduction Brace (mFAB) is made of injection molded plastic, making it easy to mass produce, and includes removable shoes with a strap to hold the heel in place, claiming to be more comfortable and easier to use, leading to improved compliance.

The MiracleFeet Foot Abduction Brace (mFAB) is a Denis Browne Splint used for the treatment of clubfoot. Use of the Denis Browne Split is standard in clubfoot treatment and the mFAB complies with the standards for foot abduction braces for clubfoot: