Comprehensive Idiopathic Clubfoot Treatment based on the Ponseti Method: The FMC, Umuahia Experience.

Background: Clubfoot is a common foot deformity worldwide. The gold standard of treatment is the Ponseti regimen, a nonoperative method comprised of manipulation, casting, percutaneous Achilles tenotomy and bracing. There has been no report on the presentation of clubfoot and Ponseti regimen from our centre.

Objectives: This study reports the pattern of the presentation of patients with idiopathic clubfoot, the factors that affected presentation to the hospital for care and the outcomes of their treatment at the Federal Medical Center, Umuahia during a 21-month period.

Methods: This is a prospective, descriptive analytical study, recruiting patients presenting consecutively with idiopathic Clubfoot at the Federal Medical Center, Umuahia during a 21-month period and treated with the standard Ponseti method. Pirani score was used for assessment and monitoring. The data were recorded and analyzed using the IBM SPSS version 20.

Results: There were 114 patients presenting with 189 feet were seen during this period. 69 of the patients were males while 45 were females. The age range at presentation was 0-16 years, with a mean of 2.3 years. 75 patients had bilateral clubfeet and 39 were unilateral, affecting 23 right and 16 left. 47 patients had previous care including the traditional bonesetting before they came to FMC, Umuahia. 55 cases have had tenotomies and 87 patients are currently on braces. There have been 9 early relapses.

Conclusion: Ponseti treatment has a good outcome in the treatment of clubfoot in children. Ignorance and poverty were major factors that hindered parents from presenting their children for Clubfoot care early. Education and free care would change this tide.