Neglected Clubfoot- a Community Health Challenge in Rural Odisha, India

Sahoo, Pabitra Kumar; Sahu, Mamata Manjari

doi:10.1007/s43465-023-00923-5

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…If clubfoot treatment is not initiated before walking age or if inadequate treatment is administered, it may lead to weight bearing on either the lateral border or dorsum of the foot. This condition is commonly referred to as neglected congenital clubfoot (NCCF) [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…In comparison to CCF, treating NCCF poses greater challenges due to the initial stiffness of the feet, resulting in a more stubborn tendency to relapse. The recurrence rate is estimated to be between 10% and 50%, irrespective of the mode of initial correction used [ 4 , 10 ]. The prevention of recurrence and residual deformities in NCCF involves strict adherence to the Ponseti method, ensuring and enforcing brace compliance, regular follow-up, and prompt treatment of recurrence [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Application of pedobarographic analysis in neglected congenital clubfoot patients following Ponseti treatment for recurrence prediction

Xu,

Wei,

et al. 2024

Heliyon

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Application of pedobarographic analysis in neglected congenital clubfoot patients following Ponseti treatment for recurrence prediction

Xu,

Wei,

et al. 2024

Heliyon

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Rigidity of foot deformity in congenital clubfoot: foot stiffness index

Vlasov

2024

Russian Journal of Pediatric Surgery, Anesthesia and Intensive

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BACKGROUND: A unified system for assessing the severity of congenital clubfoot in newborns and young children worldwide remains to be established. “Rigidity” of foot deformity refers to the degree of “resistance” of foot tissues during manual correction of elements of the deformity and is often used in subjective severity of foot deformity assessment. However, there is no objective quantitative assessment for the degree of foot rigidity. AIM: The study aimed to introduce a novel clinical sign — ”rigidity of foot deformation”, which enables objective assessment of the severity of foot deformity in congenital clubfoot. MATERIALS AND METHODS: Before applying the first plaster cast, a clinical dynamometric examination was performed on 350 feet of 229 children, followed by a mathematical calculation of the foot rigidity index. Statistical analysis was performed using the nonparametric Mann–Whitney U-test and Spearman’s rank correlation coefficient. Differences were considered significant at p 0.05. RESULTS: Significant differences were found in all clinical and dynamometric parameters between congenital clubfoot of I–II, III, and IV degrees (p ≤ 0.05). Generally, the higher the degree of deformity, the more effort required to eliminate it, the smaller angle of simultaneous correction, and the higher index of foot rigidity. The results of Spearman’s correlation analysis of clinical dynamometric examination indicators in children with congenital clubfoot of I–II degree may indicate the mobile nature of the foot deformity; III degree, a rigid version of the deformity; and IV degree, an extremely rigid degree of deformity. CONCLUSIONS: Rigidity of the foot deformity is a crucial clinical sign that characterizes the severity of the foot deformity, which has a quantitative characteristic — the rigidity index. Initial data on foot rigidity enables objective assessment of the severity of the deformity and selecting an individual approach to its elimination when applying staged plaster casts using the Ponseti method.

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Scale of severity of congenital clubfoot by the degree of rigidity of foot deformity

Vlasov

2024

Russian Journal of Pediatric Surgery, Anesthesia and Intensive

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BACKGROUND: To date, the development of scales and classification systems for congenital clubfoot mainly involves determining the severity of clinical symptoms of foot pathology. However, it does not provide a quantitative assessment of the degree of rigidity of the foot deformity. The use of a scale that determines the foot stiffness index allows individualized long-term treatment plan for each patient. AIM: This study aimed to develop a severity scale for congenital clubfoot based on the determination of the foot rigidity index. MATERIALS AND METHODS: Before treatment, 229 children (350 feet) with typical congenital clubfoot who were treated with the Ponseti method underwent a clinical dynamometric examination. Then, the foot rigidity index was calculated. The number of plaster casts required to eliminate foot deformities in patients with congenital clubfoot of I–II, III, and IV degrees was determined. The Spearman rank method was used to establish correlations between clinical and dynamometric indicators for congenital clubfoot. P 0.05 indicated significant differences. RESULTS: A retrospective analysis of the treatment of children with congenital clubfoot using the Ponseti method revealed that fewer plaster casts are required in correcting a mild deformity than in correcting a severe deformity, and a lower index of foot rigidity is noted in mild than in severe congenital clubfoot. The Spearman correlation analysis was used to identify the criterion “foot stiffness index,” which had the most number of strong correlations between the studied signs with a high statistical significance (p = 0.001). Considering the initial index of foot rigidity, three forms of congenital clubfoot were identified: mobile, rigid, and extremely rigid. The mobile form included a deformity with a rigidity index ≤0.2. The rigid form included a deformity with a foot rigidity index of 0.21–0.3. In an extremely rigid deformity, the foot rigidity index exceeds 0.31. CONCLUSIONS: The foot rigidity index is a criterion that provides a qualitative characteristic of the condition of the foot in patients with congenital clubfoot. Based on the initial foot rigidity index, congenital clubfoot can be classified as mobile, rigid, or extremely rigid.

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Neglected Clubfoot- a Community Health Challenge in Rural Odisha, India

Cited by 3 publications

References 17 publications

Application of pedobarographic analysis in neglected congenital clubfoot patients following Ponseti treatment for recurrence prediction

Application of pedobarographic analysis in neglected congenital clubfoot patients following Ponseti treatment for recurrence prediction

Rigidity of foot deformity in congenital clubfoot: foot stiffness index

Scale of severity of congenital clubfoot by the degree of rigidity of foot deformity

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