Morcuende continues his mentor’s method

Dr. Jose Morcuende meets with Aspen Galindo, age 3 weeks, and her mother, Katie Detweiler from Keota.

Dr. Jose Morcuende meets with Aspen Galindo, age 3 weeks, and her mother, Katie Detweiler from Keota.

When Jose Morcuende first came to The University of Iowa in 1990 as a visiting associate professor, his plan was to work with Ignacio Ponseti, learn the doctor’s world-renowned nonsurgical, low-cost clubfoot treatment, and take those skills back to his native Spain.

“It was never my intention to stay; I was going to return to Madrid,” says Morcuende, associate professor of orthopaedic surgery at UI Hospitals and Clinics. “It didn’t work that way. I began working with Dr. Ponseti and it just seemed natural to stay.”

Twenty-one years later, Morcuende still works at UI Hospitals and Clinics, and although Ponseti passed away in 2009, Morcuende continues to advance his mentor’s legacy by taking the Ponseti Method for clubfoot treatment around the world. He has visited 47 countries, meeting with countless parents, and teaching physicians and nonphysician health care providers how to use the Ponseti Method.

For a closer look at Jose Morcuende’s work, see fyi.uiowa.edu/09/29/morcuende-photos.

Each year, 200,000 children worldwide are born with clubfoot. There is no known cause for clubfoot, which occurs in every country, but is more prevalent in underdeveloped areas—nearly 80 percent of children born with clubfoot live in impoverished countries, Morcuende says.

Without treatment, clubfoot causes the feet to turn inward and downward. Before the low-cost Ponseti Method became available in underdeveloped countries, the only alternative was surgery, which was financially out of reach for most families, and children affected by the condition often grew up unable to work, walk, or significantly participate in their communities. The additional social costs of supporting those who can’t work meant that these children were often cast aside and regarded as useless members of society.

Morcuende’s work has changed that situation and allowed hundreds of children born with clubfoot in these countries to live normal, productive lives.

Ponseti’s treatment involves a series of five casts and a simple snipping of the heel cord to “train” the foot into normal alignment. The Ponseti Method is performed as a series of outpatient procedures that do not require a hospital stay and cost only a fraction of the amount of the surgical approach.

“This method has more advantages than just a simpler technique; it really has public health implications as well as economic ones,” Morcuende says. Because the treatment uses simple materials—plaster casts—and can be taught to nonphysician health care providers, it can be used in areas with few or no doctors, Morcuende says.

While he continues to train others in developing countries how to perform the Ponseti Method, his ultimate goal is to bring the public health perspective to light, to show communities how this simple procedure can eventually change their economic situation.

“I’m still training people, and that helps change one clinic,” he says. “How do you change one country? You have to do that through public health, which means they have to understand the impact this method can have. That is my true contribution, to improve the public health systems in those countries.

“If you change the treatment and the cost of treatment, really you are changing the public impact,” he says. “Besides learning how to work with the country, you’re changing the way the country is treating the deformity.”


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