Congenital clubfoot is a complex pediatric foot deformity, occurring in approximately 1 in 1000 live births and resulting in significant disability, deformity, and pain if left untreated. The Ponseti method of manipulation is widely recognized as the gold standard treatment for congenital clubfoot; however, its mechanical aspects have not yet been fully explored. During the multiple manipulation-casting cycles, the tendons and ligaments on the medial and posterior aspect of the foot and ankle, which are identified as the rate-limiting tissues, usually undergo weekly sequential stretches, with a plaster of Paris cast applied after the stretch to maintain the length gained. This triggers extracellular matrix remodeling and tissue growth, but due to the viscoelastic properties of tendons and ligaments, the initial strain size, rate, and loading history will affect the relaxation behavior and mechanical strength of the tissue. To increase the efficiency of the Ponseti treatment, we discuss the theoretical possibilities of decreasing the size of the strain step and interval of casting and/or increasing the overall number of casts. This modification may provide more tensile stimuli, allow more time for remodeling, and preserve the mechanical integrity of the soft tissues.

中文翻译：

---

蓬塞方法在马蹄内翻足治疗中的力学性能分析。

先天性马蹄内翻足是一种复杂的小儿足部畸形，大约每千名活产婴儿中就有1例发生畸形，如果不加以治疗，会导致严重的残疾，畸形和疼痛。庞塞梯的手法被公认为先天性马蹄内翻足的金标准治疗方法。然而，其机械方面尚未得到充分的探索。在多次操作铸造周期中，被确定为限速组织的脚和脚踝内侧和后侧的肌腱和韧带通常每周进行一次连续拉伸，拉伸后使用巴黎石膏石膏保持长度。这会触发细胞外基质重塑和组织生长，但是由于肌腱和韧带的粘弹性，初始应变大小，速率，加载历史会影响组织的松弛行为和机械强度。为了提高Ponseti处理的效率，我们讨论了减小应变步长和铸造间隔和/或增加铸造总数的理论可能性。这种修改可以提供更多的拉伸刺激，留出更多的时间进行重塑，并保留软组织的机械完整性。