Asian Journal of Orthopaedic Research

Introduction : Congenital clubfoot is a highly debilitating malformation. It is the most common malformation of the pelvic limb, with a frequency of 1 case per 100 live births. Its treatment was standardised in Cameroon in 2019. The clubfoot treatment in Cameroon used to involve costly and invasive surgeries with poor results (incomplete correction and stiffness). That is why the country adopted in 2019 the less invasive, affordable and effective Ponseti method.

Aim : This study was to determine the clinical presentation of treated clubfoot, the outcome of the Ponseti method and the local associated factors needing strategic actions.

Materials and Methods : We conducted a cross-sectional study with retrospective data collection from January 1, 2019, to December 31, 2023. We reviewed all records of clubfoot cases in children aged two years or younger who were followed up in centres approved for the Ponseti method, completed by telephone calls and appointments. All children aged 0 to 2 years old presenting with a clubfoot were treated in a clubfoot clinic by the Ponseti method. The data were analysed using SPSS software version 26. The statistical significance level was set at p< 0.05, and the confidence interval was set at 95%. 

Results : We had 445 children under the age of two and 691 clubfeet. There were 308 boys and 138 girls, giving a sex ratio of 2.23. An average of 5-7 weekly casts was required in 225 (50.6%) patients. Percutaneous tenotomy was necessary in 343 cases (77.1%). It was repeated in 11 cases (1.6%). Abduction foot braces were worn by 421 children, or 94.6%. The Iowa type was the most commonly used, with 413 cases (98.1%). The duration of wear was greater than 6 months in 80% of cases. In 272 cases (61.1%), there was no recurrence.

Factors associated with recurrence were: a distance of more than 25 km between home and the treatment centre (p=0.009), a high initial Pirani score (p=0.008), and home delivery (p=0.001).

Conclusion : Clubfoot in Cameroon is a national problem because all the 10 regions are concerned. Some regions lack clubfoot clinic and training is therefore needed for the new staff required. Old staff members also need continuous training and collaboration amelioration. A yearly national prospective follow up study will surely be more informative as well as studies on barriers. The results are encouraging, but the identified factors need emphasis.