DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20203708

Disability prevention with early screening and intervention among children with congenital clubfoot in India

Alisha Aggarwal, Anisha Aggarwal

Abstract


Background: Congenital clubfoot has an incidence of 1-9/1000 live births. Untreated clubfoot leads to physical, social, psychological, and financial burden on the family and society. Early intervention can prevent disability in the future. The aim of this study is to assess the effectiveness of an early intervention and conservative management to treat congenital clubfoot and prevent disability.

Methods: We conducted a retrospective analysis at an urban multispecialty hospital in North India among children with a diagnosis of congenital clubfoot managed with Ponseti technique (manipulation, casting, tenotomy and bracing). Descriptive statistics and chi-square test were used to measure association between variables.

Results: We had a total of 125 feet (41 bilateral, 43 unilateral). 78.5% (n=66) children were below 12 months of age with a mean age at diagnosis of 7.8 months. 70.2% (n=59) children were corrected with less than 5 casts to achieve complete correction. Tenotomy was required in 69% of children (n=58) and was statistically significant. A 100% success rate was achieved in our study.

Conclusions: Early intervention is essential to correct idiopathic/ congenital clubfoot, prevent disability and improve quality life in adulthood. National programs with a focus on prevention, surveillance, advocacy, and research are vital for universal health coverage.


Keywords


Children, Disability, Orthopaedics, Birth defect, Health policy

Full Text:

PDF

References


Subiah N. Introduction to Rashtriya Bal Swasthyia Karyakaram. IGNOU. 2018.

Mittal R, Sekhon A, Singh G, Thakral H. The prevalence of congenital orthopaedic anomalies in a rural community. Int Orthop. 1993;17(1):11-2.

Ponseti IV, Smoley EN. Congenital club foot: the results of treatment. JBJS 1963;45(2):261-344.

Bor N, Herzenberg JE, Frick SL. Ponseti management of clubfoot in older infants. Clin Orthop Relat Res. 2006;444:224-8.

Göksan SB, Bursalı A, Bilgili F, Sıvacıoğlu S, Ayanoğlu S. Ponseti. Technique for the correction of idiopathic clubfeet presenting up to 1 year of age: A preliminary study in children with untreated or complex deformities. Arch Orthop Trauma Surg. 2006;126(1):15-21.

Morcuende JA, Dolan LA, Dietz FR, Ponseti IV. Radical reduction in the rate of extensive corrective surgery for clubfoot using the Ponseti method. Pediatrics. 2004;113(2):376-80.

Malhotra R, Mohapatra A, Arora G, Choudhury P, Joshi H, Patel P. Ponseti technique for the management of congenital talipes equinovarus in a rural set-up in India: experience of 356 patients. Children. 2018;5(4):49.

Sætersdal C, Fevang JM, Fosse L, Engesæter LB. Good results with the Ponseti method: a multicenter study of 162 clubfeet followed for 2–5 years. Acta orthopaedica. 2012;83(3):288-93.

Number and percentage of population below poverty line by states: 2011-12. Available at: https://data.gov.in/resources/number-and-percentage-population-below-poverty-line-states-2011-12-based-tendulkar. Accessed on: 31 May 2020.

Ford-Powell VA, Barker S, Khan MSI, Evans AM, Deitz FR. The Bangladesh clubfoot project: the first 5000 feet. J Pediatr Orthop. 2013;33(4):40-4.

Pirani S, Naddumba E, Mathias R, Konde-Lule J, Penny JN, Beyeza T et al. Towards effective Ponseti clubfoot care: the Uganda sustainable clubfoot care project. Clin Orthop. 2009;467(5):1154-63.

Canadian International Development Agency. Available at: http://www.acdi-cida.gc.ca. Accessed on: 31 May 2020.

United Nations Development Programme: Uganda. Available at: http://www.undp.or.ug/index.php. Accessed on: 31 May 2020.