TITLE:
Management of Neglected Congenital Talipes Equinovarus: A Report from Practical Experience in Sokoto, Nigeria
AUTHORS:
Lukman Olalekan Ajiboye, Abdullallahi Bello Galadima, Nuradeen Altine Aliyu, Muhammad Abdullahi, Abdulazeez Mukhtar, Abdulrahman Hassan Muhammad, Nafiu Sanusi, Muawiyya Idris, Maryam Muhammad Hussaini, Nurudeen Hassan Amao, Rufa’i Hamza, Yakubu Basakkwace Ahmad, Aminu Hassan, Jabir Ibrahim Liman, Taofiq Tunde Oyeyiola
KEYWORDS:
Surgical Management of Neglected Congenital Talipes Equinovarus, Congenital Talipes Equinovarus, Clubfoot, Ponseti Method, Surgical Outcomes, Functional Outcomes, Quality of Life, Subarachnoid (Spinal) Anaesthesia, Gait Restoration
JOURNAL NAME:
Health,
Vol.18 No.3,
March
24,
2026
ABSTRACT: Background: Early-presenting Congenital Talipes Equinovarus (CTEV) is usually corrected non-operatively with the Ponseti method, achieving excellent outcomes. Neglected CTEV (NCTEV), however, is challenging and often requires surgery. Objectives: These are to: 1) describe clinical profiles, reasons for neglect, and treatments among NCTEV presenting after walking age; 2) assess functional satisfaction, anatomical outcomes, and quality of life after treatment; 3) examine effects of age at presentation, deformity rigidity, and anaesthesia choice on outcomes; and 4) document common surgical complications. Methods: A retrospective descriptive cross-sectional review was conducted on NCTEV cases treated surgically at Usmanu Danfodiyo University Teaching Hospital, Sokoto (July 2018-June 2025). Patients included in the study were aged ≥2 years, had primary NCTEV with surgical treatment, complete records, and ≥9-month follow-up. Exclusion criteria were incomplete data, secondary clubfoot, and non-surgical care. Data (demographics, causes of neglect, Pirani score, prior care, operative details, post-operative care, complications, outcomes like plantigrade foot, ambulation, and cosmesis) were extracted using a structured form and analysed in SPSS version 25 (p Results: Of 126 surgical clubfoot patients, 58 (46%) met criteria, aged 3 - 23 years (mean = 13.9). Females were 65.5% (F:M = 1.9:1). A total of 103 feet were affected: 45 bilateral, 9 left, and 4 right. All presented with poor Pirani score (≥5.5). All had abnormal gait: 62.1% crawled; 37.9% walked on the dorsum. Deformities included equinus, cavus, varus, and adduction, with rigid hypoplastic feet being common. Main reasons for neglect were multi-factorial, with poor awareness (82.8%), socioeconomic barriers (79.3%), insecurity (62.8%), and limited access to care (72.4%). All had initial but failed non-operative care and underwent surgery and by 6 months, all walked erect largely with support; by 9 months, all walked independently. Subarachnoid block was accepted by 67% (≥8 years). Challenges included financial constraints (84.5%), long travel distance (63.8%), insecurity (69.0%) and low parental education (70.7%). Complications were infrequent and manageable. Conclusion: Tailored surgical management of NCTEV yields excellent functional and psychosocial outcomes. Age influences deformity severity and shared decision-making. Multi-factorial neglect necessitates early case finding, public education, and strengthened primary orthopaedic services to reduce NCTEV.