Abstract
The Ponseti method of clubfoot treatment has revolutionized the clubfoot treatment. Participation of non-government organizations (NGOs) has helped expand the reach of clubfoot treatment and improve the outcomes. Establishing new clubfoot clinics may have their teething problems, which need to be anticipated and addressed for their efficient functioning. This retrospective observational study was performed using records of children enrolled in the initial 4 years of an NGO supported clubfoot clinic at a teaching public hospital. Patient details were analyzed to act as surrogate indicators of the challenges faced in the efficient delivery of care at this new clubfoot clinic. Furthermore, the authors’ suggestions would help other clinicians in starting a clubfoot clinic more effectively. Three hundred eighty-four children were enrolled in the initial 4 years. Two hundred ninety-seven children completed their cast treatment. Two hundred four (53.12%), which was more than half of all the enrolled children, had received some prior treatment. Only 86 (22.4%) children followed up for 4 years or more. A high dropout rate at different stages of treatment and follow-up was also noticed. The high dropout rate with the knowledge that most of the enrolled children had some prior treatment points to the clinicians’ and counselors’ failure to educate the parents. Electronic instead of manual data entry would play a role in tracing children in the setting of a new clubfoot clinic. A dedicated team of clinicians and counselors right from the beginning would help in gaining parental trust. Field visits by volunteers might be a useful additional strategy in improving the follow-up and the overall results.
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Acknowledgments
The authors want to acknowledge CURE India for their continued support in counseling services and free of cost braces for children with clubfeet.
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Study conceptualization was by VG and PB. Initial literature search was by PB, AJ, and NM. Data extraction from the records was done by PB, AJ, and NM. Data analysis was done by PB and VG. Manuscript preparation was done by PB. VG, AJ, and NM did proof reading and manuscript editing. All the authors approved the manuscript before its submission.
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The authors declare that they no conflicts of interest.
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All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. As the study involved review of medical records, formal ethical approval was waived off by the departmental review board.
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Informed consent was obtained from the parents of the children enrolled in the clinic.
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Informed consent for use of data for scientific purposes was obtained from the parents of the children enrolled in the clinic.
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Behera, P., Gupta, V., Mishra, N. et al. Challenges in Establishing a New Clubfoot Clinic at a Public Hospital: an Appraisal of the Initial 384 Cases. SN Compr. Clin. Med. 3, 632–636 (2021). https://doi.org/10.1007/s42399-021-00747-0
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DOI: https://doi.org/10.1007/s42399-021-00747-0