Achievement of developmental milestones in children with idiopathic clubfoot treated with Ponseti method in Lagos Nigeria

Abstract

Clubfoot, also known as congenital talipes equinovarus (CTEV), is a congenital deformity involving one foot or both. It is a relatively common birth defect occurring in about one in every 1,000 live births. No study has been carried out to determine if there is delay in gross motor milestones in children with idiopathic clubfoot treated with Ponseti method in this part of the world. This study was conducted to investigate this.

In this prospective study, 48 children with idiopathic clubfoot who were compliant with the foot abduction brace were enrolled. Parents were interviewed repeatedly to obtain the ages of achievement of 8 motor milestones and the data was stored and analysed using SPSS version 17.

Forty-eight children with mean age of 1.2 months as at first casting and a male: female ratio of 3.8:1 satisfied the inclusion criteria. Of the eight milestones studied, the mean age of achievement of one of them was significantly greater (P<0.05) compared with normative data. Pre-ambulatory and crawling milestones showed no significant difference, but independent ambulation was achieved up to 2 months later.

Although there were significant delays in upright ambulation in children with idiopathic clubfoot treated with Ponseti method, they all walked.

These findings should enable clinicians alleviate the concerns and fears of the parents of children with idiopathic clubfoot and assure them of a positive prognosis regarding developmental milestone achievement in spite of delays.

Keywords: Congenital talipes equinovarus, idiopathic clubfoot, Ponseti method, developmental milestones