TITLE:
The Factors of the Failure in the Treatment of Congenital Equinus Clubfoot Varus by the Ponseti Method at the Reference Health Care Center (CSREF) of Commune III of Bamako
AUTHORS:
Seydou Sanogo, Soumaila Diallo, Boubacar Karembé, Lassine Cissé, Almami Kire, Moussa Cissé, Abdoulaye Coulibaly, Aboubacar Touré, Boureima Traoré, Moustapha Yossi, Moussa Samaké, Drissa Diarra, Mohamed Traore, Seydou Mariko Mariko, Issa Fomba, Layes Touré, Adégné Togo
KEYWORDS:
Chess’ Factors, Club Foot, Ponseti Method, Pirani Score
JOURNAL NAME:
Surgical Science,
Vol.14 No.5,
May
31,
2023
ABSTRACT: Clubfoot malformation is the most common serious congenital anomaly affecting the foot in children. Its treatment by the
Ponseti method is simple, profitable
and widely used in the world. Objective: The objective of
this study was to identify
the factors of the failure of its treatment by the Ponseti method. Material
and Method: We carried out a retrospective and descriptive study of cases
of congenital equinus clubfoot varus at the Reference Health Care Center of Commune III of Bamako over 26 months
from September 2020 to November 2022.
Data were treated with the utmost anonymity. Result: This study was performed on 44 children seen for clubfoot: male (68%) and female (32%), with a sex ratio of 2.1. We obtained 13 cases of recidivism including 7 boys and 6 girls. We found 21 cases of unilateral and 23
bilateral; among which 9 recurrences were found against 4 in the unilateral forms. 85% of recurrences did not have
good adherence to the splint and 62% did not come regularly for follow-up consultation. We obtained 33 children with idiopathic clubfeet (75%) with a recurrence of
24%, and 7 children with secondary clubfeet
with 71 % recurrence. There was no recurrence in the postural type.
Among the recurrences, 38.5% started
treatment between 1 and 6 months, 23.1% from 0 to 1 month and 15.4% at 2
years and more. 85% of recurrences had a Pirani score between 4.5 to 6 at the
start of treatment and 15% at a score of 2.5 to 4. Conclusion: The factors of the failure of the Ponseti method
are mainly non-compliance with treatment, secondary clubfeet, and a high
Pirani score at the start of treatment.