What is a good result after clubfoot treatment? A Delphi-based consensus on success by regional clubfoot trainers from across Africa.

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What is a good result after clubfoot treatment? A Delphi-based consensus on success by regional clubfoot trainers from across Africa.


JournalPloS one
Publication date – Dec – 2017
Authors – Smythe, T; Wainwright, A; Foster, A; Lavy, C
KeywordsAfrica, Clubfoot therapy, consensus, Treatment Outcome
Open access – Yes
SpecialityTrauma and orthopaedic surgery
World region Global

Language – English
Submitted to the One Surgery Index on July 18, 2018 at 12:00 am
Abstract:

Congenital talipes equino-varus (CTEV), also known as clubfoot, is one of the most common congenital musculoskeletal malformations. Despite this, considerable variation exists in the measurement of deformity correction and outcome evaluation. This study aims to determine the criteria for successful clubfoot correction using the Ponseti technique in low resource settings through Africa.Using the Delphi method, 18 experienced clubfoot practitioners and trainers from ten countries in Africa ranked the importance of 22 criteria to define an ‘acceptable or good clubfoot correction’ at the end of bracing with the Ponseti technique. A 10cm visual analogue scale was used. They repeated the rating with the results of the mean scores and standard deviation of the first test provided. The consistency among trainers was determined with the intra-class correlation coefficient (ICC). From the original 22 criteria, ten criteria with a mean score >7 and SD 9 and SD<1.5.The consensus definition of a successfully treated clubfoot includes: (1) a plantigrade foot, (2) the ability to wear a normal shoe, (3) no pain, and (4) the parent is satisfied. Participants demonstrated good consistency in rating these final criteria (ICC 0.88; 0.74,0.97).The consistency of Ponseti technique trainers from Africa in rating criteria for a successful outcome of clubfoot management was good. The consensus definition includes basic physical assessment, footwear use, pain and parent satisfaction.

OSI Number – 10081
PMID – 29267350

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