Analysis of clubfoot clinic at a paediatric tertiary care government hospital in Karnataka

Abstract

Purpose: This study was done to give an overview of the structure, functioning and outcomes of a clubfoot clinic at a tertiary government hospital in Karnataka which is being run in collaboration with a Non-government organisation.Method: This study was based at a tertiary paediatric government hospital in Karnataka between 2010 to 2018. The clubfoot clinic has medical staffs who look into the assessment and treatment, whereas the support staffs take care of the registration, counselling, brace issue and documentation work. Then the child undergoes ponseti method of treatment for clubfoot. The data collected at the clubfoot clinic between 2010 to 2018 was compiled. It was assessed for various variables, demographic data, recurrence rate and overall outcome of the clinic.Result: We had a total of 1257 patients of whom bilateral presentation was seen in 50.43% of children. A positive family history for clubfoot was seen in 8% of patients. A majority of 44.2% patients presented to us in first three months of life and 5.3% of patients were above the age of 5 years at presentation to our clinic. Idiopathic clubfoot comprised 92.8%, syndromic associations in 5.08% and neurogenic clubfoot was seen in 2.64%. At presentation the average Pirani score of our study population was 5.5 and the average number of casts for correction was 7 casts [age 3months]. Percutaneous tenotomy of tendo achilles was done in 94%. The relapse rate in children treated by ponseti method at our centre is 22.5% who were managed by various methods. We at our tertiary care hospital were successful in attaining correction in 86.7% feet with clubfoot. The treatment protocol was completed in 356[28%] patients with no relapse after 5 years.Conclusion: A well-structured and dedicated clubfoot clinic with involvement of medical fraternity, government and non-government organisations are necessary for efficient and large-scale management of clubfoot to reduce the burden of the disease in our communities.