Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Aug 18, 2017; 8(8): 624-630
Published online Aug 18, 2017. doi: 10.5312/wjo.v8.i8.624
Ponseti method treatment of neglected idiopathic clubfoot: Preliminary results of a multi-center study in Nigeria
Olayinka O Adegbehingbe, Adeoye J Adetiloye, Ladipo Adewole, Dennis U Ajodo, Nosirudeen Bello, Oluwadare Esan, Alex C Hoover, James Ior, Omolade Lasebikan, Owolabi Ojo, Anthony Olasinde, David Songden, Jose A Morcuende
Olayinka O Adegbehingbe, Oluwadare Esan, Department of Orthopedic Surgery and Traumatology, Obafemi Awolowo University, Ile-Ife, Nigeria
Adeoye J Adetiloye, Gwarinpa General Hospital, Federal Capital Territory, Abuja, Nigeria
Ladipo Adewole, Lagos State University College of Medicine, Lagos, Lagos State, Nigeria
Dennis U Ajodo, Federal Medical Center Keffi, Keffi, Nasarawa State, Nigeria
Nosirudeen Bello, Federal Medical Center Abeokuta, Abeokuta, Ogun State, Nigeria
Alex C Hoover, Jose A Morcuende, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, United States
James Ior, David Songden, NKST Hospital Mkar, Gboko, Benue State, Nigeria
Omolade Lasebikan, National Orthopedic Hospital, Enugu, Enugu State, Nigeria
Owolabi Ojo, Federal Medical Center Ido Ekiti, Ekiti State, Nigeria
Anthony Olasinde, Federal Medical Center, Owo, Ondo State, Nigeria
Author contributions: Hoover AC designed and performed the research and wrote the paper; Adegbehingbe OO and Morcuende JA designed the research and supervised the report; Adegbehingbe OO, Adetiloye AJ, Adewole L, Ajodo DU, Bello N, Esan O, Ior J, Lasebikan O, Ojo O, Olasinde A and Songden D performed clinical treatment and provided clinical advice; all the authors contributed to this article.
Institutional review board statement: This study was performed using anonymous patient data from the International Clubfoot Registry. Copyright and information on the International Clubfoot Registry available from the Ponseti International Association, Iowa City, IA, United States.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data from the International Clubfoot Registry. Patients agreed to be a part of the registry at the commencement of treatment by written consent.
Conflict-of-interest statement: The authors have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Olayinka O Adegbehingbe, FWACS, FICS, Professor, Department of Orthopedic Surgery and Traumatology, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria. olayinkaadegbehingbe@yahoo.co.uk
Telephone: +234-36-7031367220
Received: August 25, 2016
Peer-review started: August 27, 2016
First decision: November 19, 2016
Revised: March 13, 2017
Accepted: April 18, 2017
Article in press: April 20, 2017
Published online: August 18, 2017
Abstract
AIM

To evaluate the effectiveness of the Ponseti method for initial correction of neglected clubfoot cases in multiple centers throughout Nigeria.

METHODS

Patient charts were reviewed through the International Clubfoot Registry for 12 different Ponseti clubfoot treatment centers and 328 clubfeet (225 patients) met inclusion criteria. All patients were treated by the method described by Ponseti including manipulation and casting with percutaneous Achilles tenotomy as needed.

RESULTS

A painless plantigrade foot was obtained in 255 feet (78%) without the need for extensive soft tissue release and/or bony procedures.

CONCLUSION

We conclude that the Ponseti method is a safe, effective and low-cost treatment for initial correction of neglected idiopathic clubfoot presenting after walking age. Long-term follow-up will be required to assess outcomes.

Keywords: Ponseti method, Neglected clubfoot, Nigeria, Walking age

Core tip: This is a retrospective study to evaluate the efficacy of the Ponseti method for initial correction of untreated, idiopathic clubfoot in patients above one year of age. The rate of initial correction to a painless, plantigrade foot without the need for soft tissue release was 78% in 255 evaluated clubfeet from 12 treatment centers in Nigeria. The Ponseti method, a non-operative treatment method involving serial manipulation and casting, is useful and effective for initial correction of clubfoot, even after walking age.