Good results after Ponseti treatment for neglected congenital clubfoot in Ethiopia

Ayana, Birhanu; Klungsøyr, Peter

doi:10.3109/17453674.2014.957085

Cited by 43 publications

(17 citation statements)

References 18 publications

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“…We did not find any prospective controlled studies. A total of 12 case series were identified: five from India [ 13 – 17 ], two from Nepal [ 18 , 19 ], and the remainder from Brazil [ 6 ], Turkey [ 20 ], Egypt [ 21 ], Pakistan [ 22 ], and Ethiopia [ 23 ]. In total, the studies assessed 491 patients, including 341 boys and 150 girls, aged 1 to 11 years old.…”

Section: Resultsmentioning

confidence: 99%

The Ponseti method in children with clubfoot after walking age – Systematic review and metanalysis of observational studies

Ferreira¹,

Stéfani²,

Haje

et al. 2018

PLoS ONE

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BackgroundThe prevalence of untreated congenital clubfoot among children older than walking age is higher in developing countries due to limited resources for early care after birth. The Ponseti method represents an intervention option for older, untreated children.MethodsA metanalysis was conducted of observational studies selected through a systematic review of articles included in electronic databases (Medline, Scopus, Embase, Lilacs, and the Cochrane Library) until June 2017. A pooling analysis of proportions with 95% confidence intervals (CIs) and a publication bias assessment were performed as routine. Estimates of success, recurrence, and complication rates were weighted and pooled using the random effects model.ResultsTwelve studies, including 654 feet diagnosed with congenital clubfoot in children older than walking age (older than 1 year old), were included for analysis. The rate of satisfactory outcomes found via a cluster metanalysis of proportions using the random effects model was 89% (95% CI = 0.82–0.94, p < 0.01), relative to the total analysed. The recurrence rate was 18% (95% CI = 0.14–0.24, p = 0.015), and the rate of casting complications was 7% (95% CI = 0.03–0.15, p = 0.19).ConclusionApplication of the Ponseti method in children with untreated idiopathic clubfoot older than walking age leads to satisfactory outcomes, has a low cost, and avoids surgical procedures likely to cause complications. The results obtained exhibited considerable heterogeneity.

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Section: Resultsmentioning

confidence: 99%

The Ponseti method in children with clubfoot after walking age – Systematic review and metanalysis of observational studies

Ferreira¹,

Stéfani²,

Haje

et al. 2018

PLoS ONE

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“…Characteristics of the eligible studies are presented in Table 2 and include children from one day old [ 21 ] to 10 years [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

“…Change in the mean Dimeglio score was evaluated in one study [ 25 ] and frequency of initial severity was reported with the Harrold-Walker classification in two studies [ 26 , 27 ]. Other definitions of primary outcome included: the number of days in casts [ 21 ], number of patients treated without extensive surgery [ 25 ], a plantigrade foot [ 24 , 28 , 29 ], no residual deformity [ 30 ], deformity status compared to previous visits [ 31 ] and parent reported outcomes on impact of treatment [ 32 ]. Limited definition terms included “complete correction” [ 26 ] and “satisfactory outcome” [ 25 ].…”

Section: Resultsmentioning

confidence: 99%

“…Criteria for satisfactory outcome not defined. 4% (253 feet, 194 patients) 3% Adewole 2014 [ 33 ], Nigeria Pirani score and photograph 100%; based on clinical judgement, Plantigrade functional foot 5.16% (8 feet) 6 feet Ayana 2014 [ 24 ], Ethiopia Pirani score 28/41 good results Good = correction of all deformities. 97.8% achieved score of <3 2 patients, 4 feet 8 children/ (11 feet) Kouamo 2014 [ 40 ], Togo Not reported 94% (179/190) compliant with brace wear 93.5% no visible discomfort 12.2% (5 cases) Not reported Mang’oli 2014 , Kenya Pirani score Initial correction: 96.2% (152 feet) Initial correction not defined.…”

Section: Resultsmentioning

confidence: 99%

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Assessment of success of the Ponseti method of clubfoot management in sub-Saharan Africa: a systematic review

Smythe

Mudariki

Kuper

et al. 2017

BMC Musculoskelet Disord

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BackgroundClubfoot is one of the most common congenital deformities affecting mobility. It leads to pain and disability if untreated. The Ponseti method is widely used for the correction of clubfoot. There is variation in how the result of clubfoot management is measured and reported. This review aims to determine and evaluate how success with the Ponseti method is reported in sub-Saharan Africa.MethodsFive databases were examined in August 2017 for studies that met the inclusion criteria of: (1) evaluation of the effect of clubfoot management; (2) use of the Ponseti method; (3) original study undertaken in sub-Saharan Africa; (4) published between 2000 and 2017. We used the PRISMA statement to report the scope of studies. The included studies were categorised according to a hierarchy of study methodologies and a 27-item quality measure identified methodological strengths and weaknesses. The definition of success was based on the primary outcome reported.ResultsSeventy-seven articles were identified by the search. Twenty-two articles met the inclusion criteria, of which 14 (64%) reported a primary outcome. Outcomes were predominantly reported though case series and the quality of evidence was low. Clinical assessment was the most commonly reported outcome measure and few studies reported long-term outcome. The literature available to assess success of clubfoot management is characterised by a lack of standardisation of outcomes, with different measures reporting success in 68% to 98% of cases.ConclusionWe found variation in the criteria used to define success resulting in a wide range of results. There is need for an agreed definition of good outcome (successful management) following both the correction and the bracing phases of the Ponseti method to establish standards to monitor and evaluate service delivery.Electronic supplementary materialThe online version of this article (10.1186/s12891-017-1814-8) contains supplementary material, which is available to authorized users.

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“…There have been some studies that have reported good results with conservative treatment of late presenting and relapsed clubfeet in the short to medium term evaluation (6,7,8) . However, surgical treatment remains a modality of treatment for neglected and relapsed clubfeet that fail to respond adequately to conservative treatment (1,4,5,9,10) .…”

Section: Introductionmentioning

confidence: 99%

Functional Results after Surgical Correction of Neglected and Relapsed Clubfeet

Aggarwal¹

2017

JMSCR

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Good results after Ponseti treatment for neglected congenital clubfoot in Ethiopia

Cited by 43 publications

References 18 publications

The Ponseti method in children with clubfoot after walking age – Systematic review and metanalysis of observational studies

The Ponseti method in children with clubfoot after walking age – Systematic review and metanalysis of observational studies

Assessment of success of the Ponseti method of clubfoot management in sub-Saharan Africa: a systematic review

Functional Results after Surgical Correction of Neglected and Relapsed Clubfeet

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