Expanding clubfoot treatment webinar series

Webinar 3 – Clubfoot treatment for the older child with untreated and recurrent clubfoot incorporating the Ponseti Method


About the webinar

Clubfoot treatment for the older child with untreated and recurrent clubfoot incorporating the Ponseti Method

Dr Ponseti developed his protocol for infants. However, there were doctors who were faced with much older children once they established the Ponseti method in their country in the early 21st century. These doctors were the first to try the Ponseti method on much older children. There is still a problem of many untreated cases globally which is due to lack of awareness about clubfoot, or lack of means to provide or access treatment. There are also recurrent cases of clubfoot in older children globally that need repeat treatment. This webinar discussed the latest thinking on clubfoot treatment for the older child.


Dr Mathew Varghese
MBBS, MS – Orthopaedics
Head of Orthopaedics: St Stephen’s Hospital, New Delhi, India

Dr Mathew Varghese is Honorary Director for Cure Clubfoot International, India Trust. He is a graduate and a post-graduate in orthopaedic surgery from Maulana Azad Medical College, University of Delhi. He is currently the Head of the Department of Orthopaedics, St Stephen’s Hospital, New Delhi, and served as Director of the hospital 1999- 2006. He was instrumental in changing the profile of the hospital to a super-specialty tertiary care centre even while maintaining a large community outreach programme.

He was nominated in 2018 by Bill Gates as one of the Five Heroes in the field that inspires him. He has specialized in trauma care with particular emphasis on reconstructive surgery for trauma and deformities in adult and paediatric patients.

He gave the Presidential Guest lecture at the 2018 British Orthopaedic Association Centenary year annual meeting titled ‘Orthopaedics in an unequal world – my journey from learning to understanding’. He was the first Indian to give this lecture in a hundred years of the BOA.

He was nominated Chairperson of a committee to evaluate disabilities in Children with Cerebral Palsy by the Ministry of Social Justice and Empowerment, Government of India. He received the Award of Honour for Reconstructive Surgery in Polio Patients in 1996, the National Award for Excellence in Medicine by the T. P. Jhunjunwala Foundation for the year 2004-2005, and the Distinguished Alumnus Award – 2007, Maulana Azad Medical College, New Delhi.

Global Panel Discussion

Dr Alaric Aroojis

M.S. (Ortho), D’Ortho, DNB (Ortho)
Fellowship in Paediatric Orthopaedics (USA, Singapore)
Honorary Consultant Paediatric Orthopaedic Surgeon
Lilavati Hospital, P.D. Hinduja Hospital &
Bai Jerbai Wadia Hospital for Children, Mumbai, India

Dr. Alaric Aroojis completed his medical school and Orthopaedic residency at Seth G.S. Medical College & King Edward VII Memorial Hospital, Mumbai. He worked as a Specialist Registrar at the Bai Jerbai Wadia Hospital for Children where his interest in Paediatric Orthopaedics was kindled.

He completed accredited Fellowship training in Paediatric Orthopaedics at the Alfred duPont Hospital for Children, USA and the National University Hospital, Singapore. He visited several centres in the USA, Europe and Australia for advanced training in Paediatric Orthopaedics.

He has a strong academic & research interest with over 60 publications and 10 book chapters related to Paediatric Orthopaedics & Rehabilitation. He authored a chapter in the Rockwood & Wilkins’ Textbook of “Fractures in Children”, 5th Ed 2001 & 6th Ed 2006 and serves as Editorial Board Member of several journals.

He has presented over 50 scientific papers related to Paediatric Orthopaedics at conferences, and has delivered lectures as Member of Faculty at over 250 seminars, workshops and conferences in India and abroad.

He serves on the Medical Advisory Board of the Global Clubfoot Initiative (GCI). He was awarded the Silver Jubilee Oration of the Indian Orthopaedic Association on the topic “The India Clubfoot Programme: a novel public-private partnership approach to clubfoot eradication through a nation-wide treatment programme” in 2017.

He is one of the few Paediatric Orthopaedic surgeons in India to perform complex pelvic osteotomies for congenital hip dislocation and to use minimally invasive techniques to correct difficult limb deformities in children. He is an integral part of the multi-disciplinary Spina Bifida & Cerebral Palsy Clinics and works in close association with Paediatric & Rehabilitation specialists.

Dr. Aroojis is a member of the Indian Orthopaedic Association (IOA), Bombay Orthopaedic Society (BOS), Paediatric Orthopaedic Society of India (POSI), Asia-Pacific Orthopaedic Association (APOA), SICOT, and the American Academy of Cerebral Palsy & Developmental Medicine (AACPDM). He currently serves as the Vice-President of the Paediatric Orthopaedic Society of India (POSI).

Dr Monica Paschoal Nogueira

Master of Health Sciences: Ph.D Faculty of Public Health

Orthopaedic Consultant, Hospital Servidor Público Estadual de São Paulo, Brazil

Dr Monica Nogueira graduated in medicine at the medical school of the University of São Paulo (1995), Master of Health Sciences by the Faculty of Medicine, University of São Paulo (2003) and Ph.D by the Faculty of Public Health, University of São Paulo (2011).

Specialisation in Orthopaedic and Traumatology in the areas of Paediatric Orthopaedics, Bone Lengthening and Reconstruction.

Consultant orthopaedic surgeon and preceptor of the Hospital Servidor Público Estadual de São Paulo.

She has publications in decompression of peripheral nerves, and complications in limb lengthening with presentations abroad on this subject.

Dr Nogueira participated actively in 15 Limb Deformity Courses in Baltimore as Faculty / Workshop Assistant (2000-2015).

She Coordinated Project Ponseti Brazil with 21 symposiums and coaching in Brazil and international participations; (Baltimore – EUA, IOWA – EUA, San Diego – EUA, New Orleans – EUA, Beijing – China, Guilin – China, Funchal – Madeira, Portugal, Johannesburg – South Africa, Hamburg – Germany, Buenos Aires – Argentina; Bogotá – Colombia, Cienfuegos – Cuba; Helsinki – Finland; Toronto – Canada; Sevilha, Madrid & Barcelona – Spain, Zurich – Austria).

Member of medical advisory board of Ponseti International Association Founder member of Ponseti Brasil Past president of Ponseti Latinoamerica Proposer and coordinator of the Global Grant Eradicating Clubfoot in Brazil 2016-2018.

Dr Pieter Maré

M.B.Ch.B (US), F.C.(Orth) SA (UKZN)
Head Clinical Unit: Paediatric Orthopaedics at Grey’s Hospital

Dr Pieter Maré is Head Clinical Unit: Paediatric Orthopaedics, Department of Orthopaedic Surgery Grey’s Hospital, Pietermaritzburg & University of KwaZulu-Natal South Africa.

Dr Maré is current president of the South African Paediatric Orthopaedics Society.

Research Interests:
Blount’s disease, Osteogenesis Imperfecta, Paediatric limb reconstruction, Clubfoot.

Dr Timothy Nunn

MSc, FRCS (Tr & Orth)
Medical Director, CURE Ethiopia Children’s Hospital

Dr Timothy Nunn has been working in Addis Ababa for 7 years having trained in Orthopaedic surgery from the Yorkshire Deanery and undertaking fellowships in children’s orthopaedic surgery at Sheffield Children’s Hospital.

His interest in clubfoot treatment is longstanding. This interest coincided with the huge number of walking patients presenting to CURE Ethiopia Children’s Hospital with Delayed Presenting Clubfoot who had never had treatment before.

In the last 7 years Tim has been working to establish best practice for these patients by reviewing outcomes of different treatment techniques.

Live Q&A

Professor Jacques du Toit

MBChB (SUN), FC Orth (SA), MSc. (Clin. Epi.) (SUN), PhD (Orth. Surg.) (SUN)
Head of Division of Orthopaedics, University of Stellenbosch, Head of Lady Michaelis Paediatric Orthopaedic Unit, Tygerberg Hospital

Paediatric Orthopaedic Surgeon, Steps Medical Director MBChB (SUN), FC Orth (SA), MSc. (Clin. Epi.) (SUN), PhD (Orth. Surg.) (SUN).

Head of Division of Orthopaedics, University of Stellenbosch, Head of Lady Michaelis Paediatric Orthopaedic Unit, Tygerberg Hospital. Ponseti faculty trainer (FT).

Better known as ‘Vaatjie’, Prof du Toit attended STEPS Ponseti training in 2006 and 2007 and started the Ponseti clubfoot clinic at Tygerberg Hospital. He assists secondary hospitals to set up clubfoot clinics. Dr du Toit attended the 2011 Steps South African planning meeting in Uganda with Karen Moss.

In 2012 he was co-organiser of the SAPOS 2012 Ponseti instructional course at the Stellenbosch Tygerberg medical campus. He was the chairman of the faculty for the STEPS 2013 Ponseti training in Botswana, Namibia and STEPS 2014 Ponseti training in Seychelles. Prof du Toit has published research and presented papers on clubfoot treatment on the Ponseti Method.

Prof du Toit works closely with STEPS on clubfoot treatment using Ponseti as the treatment of choice. He coordinates STEPS partnership with the South African Paediatric Orthopaedic Society, advises on medical protocol, pathway of care guidelines, and collaborates on training and planning for capacity building in southern Africa.

Karen Mara Moss

Founder and Executive Director STEPS Charity

Founder and Executive Director STEPS Charity (2005 – Current).

In July 2005, Karen diversified her career portfolio to include community work and social welfare. A passionate vision, driven by her son being born with bilateral clubfoot, led her to establish STEPS Charity NPC in South Africa.


With reference to her work with clubfoot, Karen’s special interest is patient care and the role of the parent. She has written education materials to support and motivate parents and caregivers to adhere to treatment. Her advocacy work is focused on building a strong clubfoot community, improving communication between key stakeholders, and publicity campaigns to remove the stigma and ignorance that is associated with clubfoot.

Karen considers all aspects of clubfoot treatment and the patient experience, and creates innovative solutions to barriers and challenges in resource restricted countries. She has developed an award-winning clubfoot care support programme in southern Africa that successfully implements a method from the United States within the South African state health sector.

She has organised Ponseti training for health professionals in partnership with SAPOS in South Africa, Botswana, Namibia and the Seychelles. She utilises her entrepreneurial, communication and marketing skills to build a self-sustainable solution to treating clubfoot effectively.