Socio-demographic characteristics of clubfoot patients: An observational study

Abstract

Introduction: Congenital idiopathic clubfoot is the most common birth defect of the musculoskeletal system affecting 1 in every 1000 live births each year. Despite numerous studies, the etiology and pathogenesis of clubfoot remains unknown. Till now, no epidemiological studies have been conducted in Jharkhand to assess the risk factors associated with clubfoot. Hence, this study was undertaken. Material and Methods: A descriptive case control study was conducted at Bokaro General Hospital, Bokaro, Jharkhand from April 2018 to April 2019 using structured questionnaires given to mothers of clubfoot patients (n=102) and mothers of children with no first or second degree family history of clubfoot as controls (n=102). Phenotypic characteristics was also noted. Results: Males were twice likely affected and half clubfoot cases had both feet affected. Right side was more affected in unilateral cases. Cause of clubfoot was idiopathic in 87% cases and non idiopathic in 13% cases. Positive family history was found in 12% cases. 51% clubfoot cases were first born children. Seasonal variation was not found to have association with clubfoot. None of the mothers, cases as well as controls were smoker. Maternal religion showed significant association: 20% cases were muslim compared to 5% muslim controls. Maternal age at birth of child and maternal diabetes did not show association with clubfoot. Conclusion: Males sex is twice likely affected by clubfoot and half of clubfoot cases are affected bilaterally. Right foot was more affected in unilateral cases. First born child was at risk of clubfoot. A family history of clubfoot was associated with risk of clubfoot. Maternal religion showed significant association with clubfoot. Maternal smoking, maternal diabetes and maternal age at birth of child were not found to be significantly associated with clubfoot in our study in contradiction to the numerous studies that have shown a strong association.