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Category: Volume 05 Issue 08 August 2017
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Title: Functional Results after Surgical Correction of Neglected and Relapsed Clubfeet

Authors: Vineet Aggarwal, Anjali Mahajan, Gauri Dutt Sharma

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i8.136

Abstract

Introduction: Clubfoot is a common congenital deformity. Neglected clubfeet are not uncommon in the developing world where many children are brought late for initiation of treatment. The response to conservative treatment may not be adequate so as to achieve correction of deformity in all cases. Hence, some of these cases may require surgical treatment for correction of deformity.

International clubfoot study group (ICFSG) scoring system and the FRS system of Laaveg and Ponseti are validated instruments to evaluate the results of treatment in treated clubfeet. In this study we have used both the instruments to evaluate the results of treatment of operated clubfeet in neglected and relapsed clubfeet.

Material and Methods: 25 children, 16 with unilateral deformity and 9 with bilateral deformities comprising a total of 34 feet were evaluated for morphological, radiological and functional outcomes using the ICFSG scoring system and the FRS system of Laaveg and Ponseti. Children who had completed at least two years after the index surgical procedure were included in the study.

Results: 34 feet in 25 children were available for study after the inclusion and exclusion criteria had been met. The mean duration between the index procedure and evaluation was 2.95+_ 1.5 years (range 2-7.75 years).

The ICFSG score was at a mean of 6.029+_ 3.43 (range 2-14).

The FRS score of Laaveg and Ponseti was at a mean of 86.88+_9.47 for 25 male children and 87+_5.02 for 9 female children.

Discussion: A clubfoot is a congenital deformity with a reported incidence of 1-2/1000 live births. Weight bearing tends to aggravate the deformity making it stiffer and relatively resistant to conservative treatment. Many of these clubfeet that do not respond adequately to conservative line of management require surgery to achieve correction of the deformities.

In our study nearly half of the children (15 out of 34) scored excellent on the FRS score. 20 out of 34 feet scored excellent on the ICFSG scoring. A significant negative correlation was found between the two scores (p<0.002).

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Corresponding Author

Vineet Aggarwal

IGMC, Shimla