The Assessment of Five Years Results for Congenital Talipes Equinovarus Treatment at Saint Francis Rural Referral Hospital in Kilombero, Mororgoro Tanzania

Abstract

Background: Congenital talipes equinovarus (CTEV) may be defined as a fixation of the foot in adduction. It is one of the common developmental malformations of the musculoskeletal system. To date, there is no global appropriate medical care. On addition to poverty, ignorance and inadequate health system are the major risk factors to the CTEV burden to developing countries. The Pirani scoring system is an instrumental tool for assessing both the severity of the deformity, and the progress of treatment. Objectives: To assess the CTEV treatment outcome within five years based on Ponsent method in rural referral private hospital in Kilombero, Morogoro Tanzania. Methodology: The prospective study, hospital based was carried out in a tertiary hospital. Ethical clearance was obtained from the hospital Ethics Committee. Patients who met the inclusion criteria were purposively recruited. The Pirani score of all feet were determine attending the child at the first time before initial manipulation was commenced, and was also done at each follow up visit until correction was achieved. Results: A total of 167 children were recruited of which 5 were excluded hence, 162 were included. The male to female ration was M: F 1.8:1. The Pirani score at presentation was ranging between 6 to 0.5. All candidates with clubfoot were treated primarily with padded cast as treatment phase. The stabilization phase involving tenotomy followed by foot abduction boot (FAB). The clubfoot correction achievement rate was 90.76%.The recurrent rate was 5.6%, failure rate was 3.7% noncompliance to clinic follow up and presence of other congenital malformations were two variables related to statistical management poor outcome (P-value 0.000 and 0.001 respectively). Conclusion: The Ponseti method remains the gold standard in club foot treatment, it simple, accessible and inexpensive. Since the approach requires a long-term follow-up of the child’s foot, therefore, there is a need of improving local clinic such that people in most remote area can be reached towards SDG #3 achievements.