Club foot management in the Bafoussam Baptist Healthcare center (BBHC), Cameroon: Treatment outcomes and the associated factors of relapse with the Ponseti’s technique

Hyacinte Trésor Ghassi 1, *, Franklin Chu Buh 2, 3, Faustin Atemkeng Tsatedem 1, Ange Faustine Talla Kenmogne 1, Nicaise Derole Motba Ndjomou 4 and Jean Roger Moulion Tapouh 1

1 Department of Physiotherapy and Physical Medicine, Faculty of Medicine and Pharmaceutical Sciences of University of Dschang, Dschang, Cameroon.
2 Department of Animal Biology and Conservation, Faculty of Science, University of Buea, Buea, Cameroon.
3 Panafrican Hospital Centre, Douala, Cameroon.
4 Bafoussam Baptist Healthcare Center, Bafoussam, Cameroon.
 
Research Article
GSC Advanced Research and Reviews, 2023, 14(03), 230–240.
Article DOI: 10.30574/gscarr.2023.14.3.0096
Publication history: 
Received on 14 February 2023; revised on 22 March 2023; accepted on 25 March 2023
 
Abstract: 
Background: Clubfoot is a birth defect found in about 1000 live births yearly in Cameroon and its treatment is often associated with relapses. The objective of this study was to evaluate treatment outcomes with the Ponseti’s technique and factors associated with relapses.
Methods: We conducted a 5-year retrospective study on clubfoot children at the Bafoussam Baptist Healthcare Center (BBHC). Data on age, sex, birth setting, previous treatment, pirani scoring, number of casts and follow-ups, bracing and relapse were recorded in case report forms. Data were analyzed with SPSS: 25 software; bivariate analysis was performed to determine factors associated with relapse.
Results: This study enrolled 78 clubfoot children with median age, 12 months (IQR1,24), 44 (56.4%) had undergone previous treatment elsewhere. The mean Pirani score before treatment was 4.9 [±SD: 0.9] for the left foot (LF), and 4.9 [±SD: 1] for the right (RF). The average number of casts performed was 6.5 [±SD: 1.5]. Tenotomy of the Achilles tendon was performed in 54 (69.2%) children. The mean final Pirani score was 0.9 [±SD: 0.5] for the LF and 0.8 [±SD: 0.6] for the RF. Only 5 (6.4%) cases did not wear Iowa braces and loss of sight rate was 1.3% (1/78). The relapse rate was 9.1% (7 /77). Treatment requiring >8 casts was associated with relapse (aOR: 10.35; CI [1.05-101.55]; P=0.04).
Conclusion: The Ponseti’s technique is effective in the treatment of CTEV in the West region of Cameroon. Treatment requiring more than 8 cats is a risk factor for relapse.
 
Keywords: 
Club foot; Ponseti’s technique; Relapse; Treatment outcome; Cameroon
 
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