Ponseti clubfoot management method: Initial experience with 273 clubfeet treated in a clubfoot clinic of a Nigerian regional orthopedic hospital.

OBJECTIVE

The aim of this study was to evaluate the initial experience and outcome of clubfoot treated using the Ponseti technique in a regional orthopedic hospital setting of a developing country.

METHODS

This was a retrospective review of all the clubfoot patients who were treated at the clubfoot clinic of National Orthopaedic Hospital Enugu from 1 of August 2013 to 31 January 2015.

RESULT

There were 175 patients with 273 clubfeet. The male to female ratio was 1.2:1, and the age range was 1 week to 27 years with a median age of 11 months. One hundred and fifty-one patients (86.5%) had congenital clubfoot, whereas 24 (13.5%) had acquired clubfoot. The mean Pirani score of the patients at presentation was 4. The mean number of cast sessions needed for correction was 6.3. The majority of the feet (96.6%) were treated and correction achieved with Ponseti method alone, whereas 3.4% had other additional surgical procedures. Seventy-two (41.1%) patients afforded and used foot abduction brace as prescribed. Plaster sores in 12.5% of patients were the most common complication. At a mean follow-up period of 6 months, a relapse rate of 3.4% was observed.

CONCLUSION

Ponseti clubfoot management technique alone is very effective in most cases of clubfoot in our setting. Late presentation of patients and foot abduction brace related challenges observed call for a policy response aimed at educating the public on the importance of early presentation and improving the use of foot abduction brace.