Correlation between Ponseti technique outcomes of neurogenic and idiopathic clubfoot amongst patients enrolled at AIC Cure Hospital clubfoot clinic from 2005 to 2014

Abstract

Objective: To determine the correlation between Ponseti technique outcomes of neurogenic and idiopathic CF amongst patients enrolled at AIC Cure hospital clubfoot clinic from 2005 to 2014
Design: A retrospective study in which files were randomly sampled
Setting: AIC Cure International hospital clubfoot clinic situated in Kiambu County, Kenya.
Study participants: Neurogenic and idiopathic clubfoot patients registered at clinic between 2005 and 2014
Main outcome measures: Standard tools were used to measure number of casts applied, tenotomies done, brace compliance, relapse, surgical correction, failure to correct, age at last assessment, plantigrade, pain, ability to wear shoes of choice and parental satisfaction.
Results: Among all files reviewed, 64% (n=203) of patients had idiopathic whilst 4.8% (n=15) had neurogenic clubfoot. The mean age at 1st assessment was 5 months while most patients were 109 – 120 months (10 years) at time of study. Idiopathic CF patients were casted less than neurogenic. Neurogenic CF patients had a statistically significant higher relapse rate at 60% (P= .000) and higher need for surgery (P=.017). Failure of Ponseti occurred in 3 out of 203 idiopathic and 2 out of 15 neurogenic patients. Care givers of neurogenic patients expressed less satisfaction with 16.7% being “very dissatisfied”.
Conclusion: Clinicians attending to patients with CF should consider modifying the Ponseti method to improve neurogenic patients outcomes and care giver satisfaction.