Ponseti method treatment of neglected idiopathic clubfoot: Preliminary results of a multi-center study in Nigeria

doi:10.5312/wjo.v8.i8.624

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World Journal of Orthopedics

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World J Orthop. Aug 18, 2017; 8(8): 624-630
Published online Aug 18, 2017. doi: 10.5312/wjo.v8.i8.624

Ponseti method treatment of neglected idiopathic clubfoot: Preliminary results of a multi-center study in Nigeria

Olayinka O Adegbehingbe, Adeoye J Adetiloye, Ladipo Adewole, Dennis U Ajodo, Nosirudeen Bello, Oluwadare Esan, Alex C Hoover, James Ior, Omolade Lasebikan, Owolabi Ojo, Anthony Olasinde, David Songden, Jose A Morcuende

Olayinka O Adegbehingbe, Oluwadare Esan, Department of Orthopedic Surgery and Traumatology, Obafemi Awolowo University, Ile-Ife, Nigeria

Adeoye J Adetiloye, Gwarinpa General Hospital, Federal Capital Territory, Abuja, Nigeria

Ladipo Adewole, Lagos State University College of Medicine, Lagos, Lagos State, Nigeria

Dennis U Ajodo, Federal Medical Center Keffi, Keffi, Nasarawa State, Nigeria

Nosirudeen Bello, Federal Medical Center Abeokuta, Abeokuta, Ogun State, Nigeria

Alex C Hoover, Jose A Morcuende, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, United States

James Ior, David Songden, NKST Hospital Mkar, Gboko, Benue State, Nigeria

Omolade Lasebikan, National Orthopedic Hospital, Enugu, Enugu State, Nigeria

Owolabi Ojo, Federal Medical Center Ido Ekiti, Ekiti State, Nigeria

Anthony Olasinde, Federal Medical Center, Owo, Ondo State, Nigeria

Author contributions: Hoover AC designed and performed the research and wrote the paper; Adegbehingbe OO and Morcuende JA designed the research and supervised the report; Adegbehingbe OO, Adetiloye AJ, Adewole L, Ajodo DU, Bello N, Esan O, Ior J, Lasebikan O, Ojo O, Olasinde A and Songden D performed clinical treatment and provided clinical advice; all the authors contributed to this article.

Institutional review board statement: This study was performed using anonymous patient data from the International Clubfoot Registry. Copyright and information on the International Clubfoot Registry available from the Ponseti International Association, Iowa City, IA, United States.

Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data from the International Clubfoot Registry. Patients agreed to be a part of the registry at the commencement of treatment by written consent.

Conflict-of-interest statement: The authors have no financial relationships to disclose.

Data sharing statement: No additional data are available.

Correspondence to: Olayinka O Adegbehingbe, FWACS, FICS, Professor, Department of Orthopedic Surgery and Traumatology, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria. olayinkaadegbehingbe@yahoo.co.uk

Telephone: +234-36-7031367220

Received: August 25, 2016
Peer-review started: August 27, 2016
First decision: November 19, 2016
Revised: March 13, 2017
Accepted: April 18, 2017
Article in press: April 20, 2017
Published online: August 18, 2017
Processing time: 350 Days and 9.3 Hours

Abstract

AIM

To evaluate the effectiveness of the Ponseti method for initial correction of neglected clubfoot cases in multiple centers throughout Nigeria.

METHODS

Patient charts were reviewed through the International Clubfoot Registry for 12 different Ponseti clubfoot treatment centers and 328 clubfeet (225 patients) met inclusion criteria. All patients were treated by the method described by Ponseti including manipulation and casting with percutaneous Achilles tenotomy as needed.

RESULTS

A painless plantigrade foot was obtained in 255 feet (78%) without the need for extensive soft tissue release and/or bony procedures.

CONCLUSION

We conclude that the Ponseti method is a safe, effective and low-cost treatment for initial correction of neglected idiopathic clubfoot presenting after walking age. Long-term follow-up will be required to assess outcomes.

Keywords: Ponseti method; Neglected clubfoot; Nigeria; Walking age

Core tip: This is a retrospective study to evaluate the efficacy of the Ponseti method for initial correction of untreated, idiopathic clubfoot in patients above one year of age. The rate of initial correction to a painless, plantigrade foot without the need for soft tissue release was 78% in 255 evaluated clubfeet from 12 treatment centers in Nigeria. The Ponseti method, a non-operative treatment method involving serial manipulation and casting, is useful and effective for initial correction of clubfoot, even after walking age.