PurposeWith the Ponseti treatment method established as the gold standard, children with clubfeet face a prolonged treatment regime that might impact on their families. We aimed to determine how Ponseti treatment influences the lives of parents and caregivers and what coping strategies they use. Secondarily, we aimed to identify any potential differences between two urban referral centres for clubfoot.MethodsA total of 115 parents of children affected with idiopathic clubfoot were recruited and included in two groups: one from the United Kingdom (UK) and the other from South Africa (SA). The participants completed the following three instruments: the Impact on Family Scale (IOFS), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Brief COPE.ResultsDuring the bracing phase, the IOFS showed a trend towards lower scores when compared to the casting phase for both cohorts (p = 0.247 and p = 0.434, respectively). The SA population scored higher than the UK in the MSPSS in both casting (p = 0.002) and bracing phases (p = 0.004) and used coping strategies at a significantly higher level when compared to the UK population (p < 0.05) in both treatment phases.ConclusionThis is the first study to show that Ponseti treatment for clubfoot causes an impact on family function. In SA, perceived social support is higher and coping strategies are used more often than in the UK to deal with the stressful circumstances of treatment.

Background: Acute traumatic occupational hand injuries are the second most common cause of all traumatic hand injuries worldwide and the most commonly injured body part during occupational accidents. Traumatic hand injuries account for approximately one-third of all traumatic injuries seen at state hospitals in South Africa. The aetiology of occupational hand injures in South Africa is unknown.

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Background: Despite an apparent increased burden of Blount's disease in South Africa, little is known of its epidemiology and associated features. The aim of this study is to explore the profile of South African patients with Blount's disease seen at an academic hospital, with respect to family history, ethnicity, associated milestones, sex, bilateral involvement and obesity. Methods: We retrospectively evaluated the hospital records of children diagnosed with Blount's disease (infantile, juvenile and adolescent groups) over a 14-year period, from 1 January 2003 to 31 December 2016 at Chris Hani Baragwanath Academic Hospital. Demographic information including family history, ethnicity, attainment of milestones, age when the deformity was first noticed, age at presentation, sex, bilateral involvement and body mass index were documented. Results: Data was available for 108 patients with a total of 172 involved limbs. In this series all patients were of black African origin. Data for 60 of the patients regarding family history was available-there were 12 documented cases with a positive family history of significant bow legs (20%). The developmental milestones of patients within all three groups were within normal limits and, in particular, were not early. The majority of the patients in the infantile and juvenile groups were female whereas the adolescent group had a male predominance. There was a similar occurrence of bilateral involvement in all groups (infantile group 64%, juvenile group 53% and adolescent group 61%). There was an increased percentage of individuals who were overweight or obese (according to BMI percentiles) in each of the three groups compared to normative data (infantile 76%, juvenile 86% and adolescent 88%). A greater proportion of male patients were classified as obese compared to female patients (82% versus 50%). There was however no significant difference in the BMI of patients with unilateral or bilateral deformity. Conclusion: New findings from this large South African population of children with Blount's disease were an increased occurrence of bilateral involvement in all age groups and no association with early walking-both findings are different from the international literature. Similar to other international studies, female preponderance in the infantile group and male preponderance in the adolescent group was confirmed. Other findings include an increased occurrence of obesity in male children in all groups as well as an increasing occurrence of obesity as the groups progressed from infantile (42%), to juvenile (76%), to adolescent (82%) using the CDC percentiles for age. No risk factors were found for unilateral involvement.

These findings indicate that ESOA MDR-TB is a reality in this paediatric population (10.5%) and a high index of suspicion should be maintained, especially when cultures are negative in children with signs and symptoms of ESOA TB. The effect of HIV infection on the incidence of ESOA MDR-TB requires further study.