Skip to main content

Advertisement

SpringerLink
Log in

Surgical treatment of neglected congenital idiopathic talipes equinovarus after walking age in Eritrea: an Italo-Eritrean cooperation

  • Original Article
  • Published:
MUSCULOSKELETAL SURGERY Aims and scope Submit manuscript

Abstract

An Italian team of orthopaedic surgeons joined Eritrean colleagues to perform a clinical study in ambulating children affected by neglected idiopathic congenital talipes equinovarus (clubfoot). This study reports the surgical strategy as well as clinical outcomes, early complications and relapse at a mid-term follow-up. Four expeditions of 7 days were organized between 2012 and 2015 from Italy to the Halibet Hospital of Asmara in Eritrea. In each expedition were included two experienced surgeons, two assistants and one anaesthesiologist. During these expeditions, a total of 468 patients were evaluated together with Eritrean colleagues and 45 cases of neglected talipes equinovarus in ambulating children were diagnosed and selected for surgery. Follow-up range was 1–3 years. During the four expeditions, the Eritrean team of orthopaedic surgeons learned to manage most cases of neglected talipes equinovarus. No major complications were reported. Sixteen feet were considered excellent, 25 good and four poor. No overcorrections were observed. Neglected congenital talipes equinovarus is the result of delayed treatment of congenital deformity in developing countries, and its treatment often requires extensive surgery. Collaboration with foreign expert surgeons may help local doctors to learn how to treat this disease. The current study demonstrates that surgical expeditions in developing countries, when organized in collaboration with local doctors, help to manage on site this severe deformity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Ponseti IV, Smoley EN (1963) Congenital clubfoot: the results of treatment. J Bone Joint Surg Am 45:261–344

    Google Scholar 

  2. Masse P (1977) Le traitement du pied bot par la methode ‘‘fonctionelle’’. Cahier d’enseignement de la SOFCOT, vol 3. Expansion Scientifique, Paris, France, pp 51–56

    Google Scholar 

  3. Morcuende JA, Abbasi D, Dolan LA, Ponseti IV (2005) Results of an accelerated Ponseti protocol for clubfoot. J Pediatr Orthop 25:623–626

    Article  PubMed  Google Scholar 

  4. Colburn M, Williams M (2003) Evaluation of the treatment of idiopathic clubfoot by using the Ponseti method. J Foot Ankle Surg 42:259–267

    Article  PubMed  Google Scholar 

  5. Gupta A, Singh S, Patel P, Patel J, Varshney MK (2008) Evaluation of the utility of the Ponseti method of correction of clubfoot deformity in a developing nation. Int Orthop 32:75–79

    Article  PubMed  Google Scholar 

  6. Jowett CR, Morcuende JA, Ramachandran M (2011) Management of congenital talipes equinovarus using the Ponseti method: a systematic review. J Bone Joint Surg Br 93:1160–1164

    Article  CAS  PubMed  Google Scholar 

  7. Changulani M, Garg NK, Rajagopal TS, Bass A, Nayagam SN, Sampath J, Bruce CE (2006) Treatment of idiopathic clubfoot using the Ponseti method. Initial experience. J Bone Joint Surg Br 88:1385–1387

    Article  CAS  PubMed  Google Scholar 

  8. Herold HV, Torok G (1973) Surgical correction of neglected clubfoot in the older child and adult. J Bone Joint Surg Am 55:1385–1395

    CAS  PubMed  Google Scholar 

  9. Loza ME, Bishay SN, El-Barbary HM, Hanna AA, Tarraf YN, Lotfy AA (2010) Double column osteotomy for correction of residual adduction deformity in idiopathic clubfoot. Ann R Coll Surg Engl 92:673–679

    Article  PubMed  PubMed Central  Google Scholar 

  10. Turco VJ (1971) Surgical correction of the resistant club foot. One-stage posteromedial release with internal fixation: a preliminary report. J Bone Joint Surg Am 53:477–497

    CAS  PubMed  Google Scholar 

  11. Turco VJ (1979) Resistant congenital club foot one-stage posteromedial release with internal fixation. A follow-up report of a fifteen-year experience. J Bone Joint Surg Am 61:805–814

    CAS  PubMed  Google Scholar 

  12. Mahadev A, Munajat I, Mansor A, Hui JH (2009) Combined lateral and transcuneiform without medial osteotomy for residual clubfoot for children. Clin Orthop Relat Res 467:1319–1325

    Article  PubMed  PubMed Central  Google Scholar 

  13. Hassan FO, Jabaiti S, El Tamini T (2010) Complete subtalar release for older children who had recurrent clubfoot deformity. Foot Ankle Surg 16:38–44

    Article  PubMed  Google Scholar 

  14. Codivilla A (1905) On the means of lengthening, in the lower limbs, the muscles and tissues which are shortened through deformity. Am J Orthop Surg 22:353–369

    Google Scholar 

  15. Kuo KN, Smith PA (2009) Correcting residual deformity following clubfoot releases. Clin Orthop Relat Res 467:1326–1333

    Article  PubMed  Google Scholar 

  16. Thompson G, Hoyen H, Barthel T (2009) Tibialis anterior tendon transfer after clubfoot surgery. Clin Orthop Relat Res 467:1306–1313

    Article  PubMed  PubMed Central  Google Scholar 

  17. Elgeidi A, Abulsaad M (2014) Combined double tarsal wedge osteotomy and transcuneiform osteotomy for correction of resistant clubfoot deformity (the “bean-shaped” foot). J Child Orthop 8:399–404

    Article  PubMed  PubMed Central  Google Scholar 

  18. Holt JB, Oji DE, Yack HJ, Morcuende JA (2015) Long-term results of tibialis anterior tendon transfer for relapsed idiopathic clubfoot treated with the Ponseti method: a follow-up of thirty-seven to fifty-five years. J Bone Joint Surg Am 97:47–55

    Article  PubMed  Google Scholar 

  19. Faldini C, Traina F, Di Martino A, Nanni M, Acri F (2013) Can selective soft tissue release and cuboid osteotomy correct neglected clubfoot? Clin Orthop Relat Res 471:2658–2665

    Article  PubMed  PubMed Central  Google Scholar 

  20. Dietz F (2002) The genetics of idiopathic clubfoot. Clin Orthop Relat Res 401:39–48

    Article  PubMed  Google Scholar 

  21. Owen RM, Kembhavi G (2012) A critical review of interventions for clubfoot in low and middle-income countries: effectiveness and contextual influences. J Pediatr Orthop B 21:59–67

    Article  PubMed  Google Scholar 

  22. Laaveg SJ, Ponseti IV (1980) Long-term results of treatment of congenital club foot. J Bone Joint Surg Am 62:23–31

    CAS  PubMed  Google Scholar 

  23. Ippolito E, Farsetti P, Caterini R, Tudisco C (2003) Long-term comparative results in patients with congenital clubfoot treated with two different protocols. J Bone Joint Surg Am 85:1286–1294

    PubMed  Google Scholar 

  24. Zhao D, Li H, Zhao L, Liu J, Wu Z, Jin F (2014) Results of clubfoot management using the Ponseti method: do the details matter? A systematic review. Clin Orthop Relat Res 472:1329–1336

    Article  PubMed  PubMed Central  Google Scholar 

  25. Siapkara A, Duncan R (2007) Congenital talipes equinovarus: a review of current management. J Bone Joint Surg Br 89:995–1000

    Article  CAS  PubMed  Google Scholar 

  26. Uglow MG, Kurup HV (2010) Residual clubfoot in children. Foot Ankle Clin 15:245–264

    Article  PubMed  Google Scholar 

  27. Mehrafshan M, Rampal V, Seringe R, Wilcart P (2009) Recurrent clubfoot deformity following previous soft-tissue release: mid-term outcome after revision surgery. J Bone Joint Surg Br 91:949–954

    Article  CAS  PubMed  Google Scholar 

  28. Hallaj-Moghadam M, Moradi A, Ebrahimzadeh MH (2015) Clinical outcome of posteromedial versus posteromedial-lateral release for clubfoot. J Pediatr Orthop B 24:24–27

    Article  PubMed  Google Scholar 

  29. Radler C (2013) The Ponseti method for the treatment of congenital club foot: review of the current literature and treatment recommendations. Int Orthop 37:1747–1753

    Article  PubMed  PubMed Central  Google Scholar 

  30. Verma A, Mehtani A, Sural S, Maini L, Gautam VK, Basran SS, Arora S (2012) Management of idiopathic clubfoot in toddlers by Ponseti’s method. J Pediatr Orthop B 21:79–84

    Article  PubMed  Google Scholar 

  31. Lourenco AF, Morcuende JA (2007) Correction of neglected idiopathic club foot by the Ponseti method. J Bone Joint Surg Br 89:378–381

    Article  CAS  PubMed  Google Scholar 

  32. Garg S, Dobbs MB (2008) Use of the Ponseti method for recurrent clubfoot following posteromedial release. Indian J Orthop 42:68–72

    Article  PubMed  PubMed Central  Google Scholar 

  33. Dobbs MB, Gurnett CA (2009) Update on clubfoot: etiology and treatment. Clin Orthop Relat Res 467:1146–1153

    Article  PubMed  PubMed Central  Google Scholar 

  34. Bor N, Herzenberg JE, Frick S (2006) Ponseti management of clubfoot in older infants. Clin Orthop Relat Res 444:224–228

    Article  PubMed  Google Scholar 

  35. Cosma DI, Vasilescu DE (2014) Ponseti treatment for clubfoot in Romania: a 9-year single-centre experience. J Pediatr Orthop B 23:512–516

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Authors would like to thank Dr. Franco Riboldi for having carried on this project and Prof. Alessandro Faldini for his invaluable teaching.

Author information

Authors and Affiliations

  1. Istituto Ortopedico Rizzoli, Bologna, Italy

    C. Faldini, F. Traina & M. Nanni

  2. University of Bologna, Bologna, Italy

    C. Faldini, L. Prosperi & C. Pungetti

  3. Halibet Hospital, Asmara, Eritrea

    S. Tesfaghiorghi, S. Tsegay & M. Yosief

  4. University of Messina, Messina, Italy

    I. Sanzarello

Authors
  1. C. Faldini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L. Prosperi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. Traina
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Nanni
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S. Tesfaghiorghi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S. Tsegay
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. Yosief
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. C. Pungetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. I. Sanzarello
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. Faldini.

Ethics declarations

Conflict of interest

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Faldini, C., Prosperi, L., Traina, F. et al. Surgical treatment of neglected congenital idiopathic talipes equinovarus after walking age in Eritrea: an Italo-Eritrean cooperation. Musculoskelet Surg 100, 133–137 (2016). https://doi.org/10.1007/s12306-016-0398-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12306-016-0398-z

Keywords

Search

Navigation