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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

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Surgical Science 2023年第5期14卷 398-404页

作者： 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 Department of Orthopedic-Traumatology CSREF CIII Bamako Mali

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.

关键词： Chess’ Factors Club Foot Ponseti Method Pirani Score

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