17 years after Priya Permaul received life-changing, clubfoot treatment in Grand Rapids, Priya’s son, Jonathan Khan, arrived in West Michigan to have his severely clubbed feet corrected. The treatment was a collaboration between the Foot & Ankle Specialists of West Michigan and Healing the Children Michigan-Ohio, a nonprofit that helps underserved children throughout the world secure urgent medical assistance they otherwise are unable to obtain.
Escorted by an American Airlines Ambassadors, Jonathan travelled from Ghana to Grand Rapids in July 2019. He was met by his host parents, Hudsonville residents Carol and Bryan Nyeholt. The same couple hosted Priya in 2002. Six days after Jonathan’s arrival, the arduous task of straightening his little feet began.
Foot & Ankle Specialists of West Michigan’s Drs. Michael and Brianna David used the Ponseti method to treat Jonathan. Their colleague, Dr. Timothy Hulst, treated Priya in 2002.
Dr. Michael David spent time training directly with Dr. Ponseti at the University of Iowa to master the technique.
In the 1940s, Dr. Ignacio Ponseti, a pediatric orthopedist at the University of Iowa, developed a method of manipulating and remolding the club foot using a series of plaster casts. After the feet are straightened, a minor surgery is performed to clip the Achilles tendon. Then for three months, the child wears a brace that consists of shoes attached to a bar. After that, a brace is worn at night for four to five years.
“Traditional surgery to treat clubfoot is a very invasive procedure,” Dr. Michael David said. “It creates scars and forcibly puts the foot into a normal position, which results in a stiff, painful in the adult patient.”
Compared to traditional corrective surgery, the Ponseti method yields a success rate of greater than 80 percent, allowing children to function normally, run and play sports.
“Treating children with clubfeet is an extremely rewarding experience,” Dr. Michael David said. “If I can make an impact on a child’s life, improve their daily function, and return them to normal physical activity, it will have a major impact on their life.”
Carol took Jonathan to the Foot & Ankle Specialists of West Michigan every seven to 10 days for three months. At each visit, the old cast was replaced by a new one.
In October, Dr. Michael David released Jonathan’s Achilles tendons and fitted him with a new cast. Three weeks later, Jonathan received a pair of shoes connect at the heels by a metal bar. Jonathan returned home to Ghana in December 2019 – three months early – because his mom was familiar with the protocol.
“Jonathan is a sweet, fun-loving, super happy kid. He was a joy to have in our home, and we are blessed to have been able to care for him,” Carol said. “We didn’t intend to begin a healing legacy when we offered medical care and love to Jonathan’s mom so many years ago, but we’re so very glad we did. Many thanks to all who had a hand in the healing then and now.”
Over the years, Dr. Michael David has seen most cases resolve the condition without any major surgical intervention. Every year, he treats anywhere from five to 10 patients with clubfoot, some who live in West Michigan and others, like Jonathan, who come to the United States from around the world to seek treatment.
“If you understand the anatomy of the deformity, then you are able to mold the foot much more successfully,” Dr. Michael David said.
According to Dr. Michael David, clubfoot affects one in 1,000 babies and is the most common congenital condition of the foot and ankle. In about 40 percent of cases, both feet are affected.