Early outcome of Ponseti Management of Idiopathic Clubfoot at the University Teaching Hospital Lusaka, Zambia

Abstract

Ponseti technique as a management method of Congenital Talipes equinovarus had not been evaluated as a treatment tool for the clubfoot in Zambia.The study set out to look at the early clinical outcome of Ponseti management of virgin idiopathic clubfoot.The study was a prospective cohort study carried out at University Teaching Hospital orthopaedic clinic for a period of six months from April 2009 to October 2009. Convenience sampling was used to select cases, 42 cases representing 62 feet were recruited for the study. The average age at which manipulations were started was 10.52 weeks and patients were followed up for an average of 8 weeks before the early clinical outcome could be assessed. Feet that progressed to Pirani score of zero and had supple mobile joints were considered a satisfactory outcome and those that needed further surgery, an unsatisfactory outcome. The study findings showed satisfactory outcome in 89% of the feet. There was an association between age (at which manipulations were started), severity of clubfoot and the early clinic outcome. Poor outcome was associated with severe feet when manipulations were commenced late. There was no association found between clubfoot type (unilateral or bilateral) and early clinical outcome. Percutaneous tenotomy of tendo achilles was done in 66% of the feet with 0% complication rate. Patients with severe clubfoot were more likely to undergo percutaneous tenotomy of tendo achilles (PTAT).