Published: 2020-01-27

Outcome of clubfoot treatment in the pre-ponseti period in a Nigerian teaching hospital: a 14 year review

Olugboyega A. Oyewole, Mosimabale J. Balogun, Richard A. Omoyeni, Samuel O. Ogunlade


Background: Congenital Talipes Equinovarus (CTEV) is a common musculoskeletal congenital disorder. Historically, surgical treatment of various types was popular; however, currently the gold standard of treatment is non-operative care using the Ponseti method. This work evaluates the outcome of this former method of managing CTEV before author adopted the Ponseti Method and compares it with the reported outcomes of the Ponseti method in published literature.

Methods: A retrospective review of this data from January 1990 to December 2003 was done, the patients demographics, treatment given, duration and outcome of care were analysed using descriptive statistics. This finding was then compared with outcomes of Ponseti method in literature.

Results: Here, 145 patients had initial non operative care; eighteen of those patients (12.4%), eventually require either a posteromedial release, a combined posteromedial and posterolateral releases or a triple arthrodesis.

Conclusions: The study shows that the success rate of this method of manipulation preceding the adoption of the Ponseti method is 87.6%. This outcome is inferior when compared to the outcome of Ponseti method in published literature. Also, the extensive nature of eventual surgical intervention required to achieve correction is in contrast to the minimal surgeries needed achieve correction of residual deformities following the use of the Ponseti method.


Congenital talipes equinovarus, Low income countries, Pre-Ponseti period, Ponseti method

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Boakye H, Nsiah A, Thomas A, Bello AI. Treatment outcome of Ponseti method in the Management of Club Foot at Komfo Anokye teaching hospital, Ghana: a retrospective study. Archies Curr Res Intern. 2016;18:1-8.

Omololu B, Ogunlade SO, Alonge TO. Pattern of congenital orthopeadic malformations in an African teaching hospital. West African J Med. 2005;24(2):92-5.

Orimolade EA, Ikem IC, Akinyoola AL, Adegbehingbe OO, Oginni LM, Esan O. Pattern of Congenital Musculoskeletal Abnormalities in South West, Nigeria: A Hospital Based Study. Niger J Orthopaed Trauma. 2013;12(1):52-5.

Adewole OA, Giwa SO, Kayode MO, Shoga MO, Balogun RA. Congenital club foot in a teaching hospital in Lagos, Nigeria. African J Med Med Sci. 2009;38(2):203-6.

Macnicol MF. The management of club foot: issues for debate. The J bone joint surg. Brit Volume. 2003;85(2):167-70.

Halanski MA, Davison JE, Huang JC, Walker CG, Walsh SJ, Crawford HA. Ponseti method compared with surgical treatment of clubfoot: a prospective comparison. JBJS. 2010;92(2):270-8.

Cummings RJ, Davidson RS, Armstrong PF, Lehman WB. Congenital clubfoot. JBJS. 2002;84(2):290.

Cooper DM, Dietz FR. Treatment of idiopathic clubfoot. A thirty-year follow-up note. The Journal of bone and joint surgery. Am Vol. 1995;77(10):1477-89.

Ponseti IV. Idiopathic congenital talipes equino-varus. In: Ponseti IV, eds. Congenital Clubfoot Fundamentals of Treatment. 1st ed. New York: Oxford University Press Inc. 1996:448-454.

Kumar R. Management of idiopathic clubfoot by Ponseti’s method: a comparative clinical study on toddlers with radiological correlation. Int J Res Orthop. 2016;2(2):52.

Akintayo OA, Adegbehingbe O, Cook T, Morcuende JA. Initial program evaluation of the Ponseti method in Nigeria. Iowa Orthop J. 2012;32:141.

Adewole OA, Williams OM, Kayode MO, Shoga MO, Giwa SO. Early experience with Ponseti Club foot management in Lagos, Nigeria. East Central African J Surg. 2014;19(2):72-7.

Herzenberg JE, Radler C, Bor N. Ponseti versus traditional methods of casting for idiopathic clubfoot. J Pediatr Orthop. 2002;22(4):517-21.

Pavone V, Testa G, Alberghina F, Lucenti L, Sessa G. Effectiveness of Ponseti method for the treatment of congenital talipes equinovarus: personal experience. Pediat Therapeut. 2015;5(3):1-4.

Morcuende JA, Dolan LA, Dietz FR, Ponseti IV. Radical reduction in the rate of extensive corrective surgery for clubfoot using the Ponseti method. Pediatr. 2004;113(2):376-80.

Smythe T, Chandramohan D, Bruce J, Kuper H, Lavy C, Foster A. Results of clubfoot treatment after manipulation and casting using the Ponseti method: experience in Harare, Zimbabwe. Trop Med Int Health. 2016;21(10):1311-8.

Munambah N, Chiwaridzo M, Mapingure T. A cross-sectional study investigating impressions and opinions of medical rehabilitation professionals on the effectiveness of the Ponseti method for treatment of clubfoot in Harare, Zimbabwe. Archiv Physioth. 2016;6(1):7.