Outcome of Treatment of Clubfoot at the Korle Bu Orthopaedic Unit Using the Ponseti Method

Abstract

Clubfoot deformity is common in Ghana and the understanding of the deformity is woefully inadequate among the general population. The current approach in the treatment of idiopathic clubfoot has focused on conservative techniques. The Ponseti technique has superior outcomes. This involves weekly manipulations and casting of the clubfoot to gradually correct the clubfoot. The functional result is good with the painfree and plantigrade foot after treatment very acceptable to the parents. This charpter addresses the predictiveness of the Pirani score in determining the number of casts in the treatment of Clubfoot at Korle-Bu Orthopaedic Unit using the Ponseti method. Each clubfoot was evaluated using the Pirani score at two weekly intervals with scores documented. Abduction brace was applied at full correction until age four years. There were 74 respondents made of 31 (42%) females and 43 (58%) males. The highest score at the beginning of treatment was 5 and at the end of treatment it dropped to zero in some cases. Overall mean score at 6 weeks was 2.5, at 10 weeks was 2.1 and at 16 weeks was 1.9. The highest drop in score occurred within the first 6 weeks. The Ponseti method is an effective method of treating idiopathic clubfeet. When started early, its outcome can be predicted with the Pirani score. Most of the correction took place in the first six weeks of casting. The Ponseti method is cost effective with excellent results and appeals to resource constrained nations including Ghana.