Bilateral congenital idiopathic clubfoot treatment with the Ponseti technique in Umuahia: A comparison of individual foot characteristics

Background: Clubfoot is the commonest musculoskeletal congenital deformity affecting the foot. The idiopathic variety is the most common type and worldwide the agreed treatment method is the Ponseti method. In bilateral cases, the feet may have different anthropometric characteristics. These differences were evaluated in this study. Objective: To assess the effect of the differences in the anthropometric parameters of the legs and feet (Calf circumference, foot length, degrees of cavus, adduction and equinus and Pirani score) in a child with bilateral clubfoot on the treatment outcome and recurrence of the deformity. Method: This was a prospective study that analyzed idiopathic bilateral clubfoot patients aged 0-5 years and treated using the Ponseti Technique at Federal Medical Center, Umuahia from October 2019 to September 2020. The Pirani scores, the lengths of the feet, the calf circumferences and degrees of cavus, adduction and equinus were measured at initial presentation, commencement of bracing and 3 months after commencement of treatment. These measurements were then compared. Results: A total of 47 patients participated in the study with a male preponderance. The right calf circumference and length of the right foot were consistently bigger than the left at each measurement; and these differences were statistically significant. The degrees of cavus, adduction and equinus were significantly worse on the right foot at presentation. Thirty-six patients (76.6%) had the same Pirani score on both feet at presentation. The differences in anthropometry parameters did not predict the number of casts needed to correct the deformity, the need for tenotomy nor the recurrence of the deformity. Conclusion: Although there were differences in the lower limb anthropometry of children with bilateral clubfoot, they did not predict deformity correction nor recurrence.