A controlled study of modified Ponseti technique combined with external application of Chinese herbs in preventing and treating skin complications during casting period for clubfoot

Kadeer Yiming; Zhang Xiaoqun; Guo Wentao

doi:10.3760/j.issn.1673-4777.2026.07.021

Abstract：Objective To investigate the effect of modified Ponseti technique combined with external application of Chinese herbs for"promoting blood circulation and removing blood stasis,relaxing sinews and activating collaterals"on skin complications during the casting period in children with clubfoot.Methods A total of 80 children with clubfoot treated at the First Affiliated Hospital of Xinjiang Medical University from January 2022 to January 2025 were enrolled.The children were randomly divided into control group and observation group by random number table method,with 40 cases in each group.According to the dropout criteria,3 cases dropped out in each group,and 37 cases were finally included in each group.The control group received traditional Ponseti technique with vaseline gauze for skin protection,and the observation group was treated with modified Ponseti technique combined with external application of traditional Chinese medicine gel patches.The incidence of skin complications,skin condition,pain level,transforming growth factor-β1(TGF-β1),interleukin-6(IL-6),microcirculation evaluation,biomechanical monitoring and curative effect were compared between the two groups.Results The total incidence of skin complications in the observation group was significantly lower than that in the control group[8.1％(3/37)vs 40.5％(15/37)](x2=10.571,P=0.001).After treatment,the Braden Q scores in both groups were higher than those before treatment,and the score in the observation group was higher than that in the control group;the faces,legs,activity,cry,and consolability scale scores in both groups were lower than those before treatment,and the score in the observation group was lower than that in the control group(all P＜0.05).TGF-β,in both groups showed a continuous increasing trend before treatment,at 4 weeks of treatment and at cast removal;IL-6 in the control group showed a trend of first increasing and then decreasing,while that in the observation group showed a continuous decreasing trend;at 4 weeks of treatment and at cast removal,TGF-β1 in observation group were higher than those in the control group,and IL-6 were lower than those in the control group(all P＜0.05).After treatment,the blood perfusion in both groups was higher than that before treatment,and that in the observation group was higher than that in the control group;the contact pressure,shear force and pressure-time integral in both groups were lower than those before treatment,and those in the observation group were lower than those in the control group(all P＜0.05).The total effective rate of the observation group was significantly higher than that of the control group[94.6％(35/37)vs 75.7％(28/37)](x2=5.234,P=0.022).Conclusion Modified Ponseti technique combined with external application of traditional Chinese medicine gel patches for"promoting blood circulation and removing blood stasis,relaxing sinews and activating collaterals"can significantly reduce the incidence of skin complications during cast fixation in children with clubfoot,relieve skin pain,improve skin condition and significantly increase the total effective rate.Its mechanism is related to improving microcirculation,regulating inflammatory repair balance and optimizing biomechanical environment.