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Walk for life ‐ the National Clubfoot Project of Bangladesh: the four‐year outcomes of 150 congenital clubfoot cases following Ponseti method

Overview of attention for article published in Journal of Foot and Ankle Research, November 2016
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Title
Walk for life ‐ the National Clubfoot Project of Bangladesh: the four‐year outcomes of 150 congenital clubfoot cases following Ponseti method
Published in
Journal of Foot and Ankle Research, November 2016
DOI 10.1186/s13047-016-0175-0
Pubmed ID
Authors

Angela Margaret Evans, Mohommad Mamun Hossen Chowdhury, Mohommad Humayun Kabir, Fashiur Rahman

Abstract

Congenital clubfoot deformity can cause significant disability, and if left untreated, may further impoverish those in developing countries, like Bangladesh. The Ponseti method has been strategically introduced in Bangladesh by a non-government organisation, Walk For Life (WFL). WFL has provided free treatment for over 17,500 Bangladeshi children with clubfeet since 2009, sustained by local ownership, and international support. This study assesses the 4-year results in children for whom treatment began before the age of 3 years. A centrally located WFL clinic at Mymensingh Medical College Hospital (MMCH), representative of the larger WFL clinics, which treats >100 cases annually, was reviewed. In 2015, 99 of the 147 eligible subjects who had begun treatment in 2011 were available for follow up. Specific assessment tools enabled evaluation of parent satisfaction, gait function, and relapse cases. Results for 99/147 cases were returned after four years: 72 males, 27 females. Typical clubfeet comprised 98/99 of cases, and 55/99 were bilateral. The tenotomy rate was 80 %. Brace use after 3 months was 90 %, at 12 months was 65 %, and at 4 years post treatment was 40 %. Functionally, 98/99 of children could walk and run (99 %). Relapsing deformity was found in 13 %. Relapse severity varied: eight were flexible and partial, five were rigid. Half of the children lost to follow were due to changed phone numbers. While parents were very happy with their child's feet (97 %), a materials cost of 3000 Taka ($US40) was deemed unaffordable by 60 %. The 4-year outcomes after Ponseti treatment for clubfoot deformity, showed that 99 % of children available for follow up, were walking independently. The relapse rate was low. Parent satisfaction was high, but those whose children required further treatment were less satisfied.

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Geographical breakdown

Country Count As %
Unknown 97 100%

Demographic breakdown

Readers by professional status Count As %
Student > Postgraduate 14 14%
Student > Bachelor 14 14%
Researcher 12 12%
Student > Master 12 12%
Student > Ph. D. Student 6 6%
Other 13 13%
Unknown 26 27%
Readers by discipline Count As %
Medicine and Dentistry 33 34%
Nursing and Health Professions 15 15%
Social Sciences 4 4%
Psychology 3 3%
Biochemistry, Genetics and Molecular Biology 2 2%
Other 11 11%
Unknown 29 30%