Clubfoot Treatment and Management
Clubfoot, also known as congenital talipes equinovarus (CTEV), is a prevalent congenital birth deformity of the foot resulting from abnormal development of a baby’s bones, ligaments, and muscles in utero, making the foot twisted out of shape in an inward position.
The cause of clubfoot is unknown, but babies with clubfoot are usually otherwise healthy. Despite its appearance, clubfoot itself doesn't cause any discomfort or pain. The treatment, especially using the ponseti method, is usually successful.
The deformity may impact one or both feet and the condition is more common among boys, with a ratio of 2:1 compared to girls. Global prevalence is estimated at 1 in every 1000 births, although the figures may vary by country due to numerous factors. Approximately 9.8 million people live with clubfoot with 7.8 million of the experience disability due to inadequate access to proper treatment. While an estimated 200,000 children are born with clubfoot worldwide, there are approximately 10,000 cases occurring annually in Nigeria.
The treatment for clubfoot consists of two phases: Ponseti serial casting and bracing. Treatment is always necessary, because the condition does not get better with growth. The Ponseti technique of serial casting is a treatment method that involves careful stretching and manipulation of the foot and holding with a cast. The first cast is applied one to two weeks after the baby is born. The cast is then changed every 7 to 10 days. With the fourth or fifth cast, a small in-office procedure maybe needed to lengthen the Achilles tendon (tenotomy). This is done using a local numbing medicine and small blade. Afterward, the baby is placed into one last cast, which remains on for two to three weeks. The entire process is inexpensive, non-surgical, and can be performed by a trained doctor, nurse, physio-therapist, or paramedical technician.
We (HANDS) focus on enhancing our capacity for clubfoot management through internal and external training of clinical staff resulting in improved skills and quality of care for clinic partners. Our organization, in collaboration with MiracleFeet, organizes clubfoot training for clinic providers, and trained clinicians on the Basic Ponseti method and ICT personnel for the CAST Comcare app.
We also provide patients with free clubfoot management and supply essential consumables to clinics, reducing the financial burdens on families. We also engage in various activities such as fact-finding for new clinics, supportive supervision visits, and public awareness campaigns to increase early detection and referral of children born with clubfoot.
The clubfoot programme through HANDS in Nigeria currently covers 18 clinics across 11 states and the FCT. The states involved are; Adamawa, Bauchi, Benue, Borno, Gombe, Kano, Lagos, Nasarawa, Plateau, Taraba, and Yobe.
