Surgery no Longer Necessary in Clubfoot Treatment — Orthopaedic Professor
By Angela Onwuzoo
A Professor of Orthopaedic and Trauma Surgery, Mike Ogirima, has said congenital clubfoot (present at birth) also known as idiopathic clubfoot can be successfully treated without surgery, using manipulative technique.
The manipulative technique also known as the Ponseti method is a nonsurgical treatment for clubfoot that uses casts and braces to help the child’s foot function normally.
Ogirima, a past President of the Nigerian Medical Association, said clubfoot could be effectively treated through physical manipulations.
He explained that surgery was no longer necessary in the treatment of idiopathic clubfoot since the manipulative treatment approach was adopted.
The surgeon, however, said the cause of idiopathic clubfoot is unknown.
He noted that untreated clubfoot results in a lifetime disability, causing pain, difficulty walking, stigmatisation, and limited access to education and economic opportunities.
Speaking in an exclusive interview with PUNCH Healthwise, the don disclosed that to eliminate disability caused by clubfoot in Nigeria, parents of children born with congenital deformities must present them early for treatment.
According to the Cleveland Clinic, clubfoot is a congenital (present at birth) condition in which a baby’s foot or feet turn inward.
Approximately one in every 1,000 babies the clinic states will be born with clubfoot, which makes it one of the more common congenital foot deformities.
“Clubfoot happens because of an issue with your child’s tendons, the tissues that connect muscle to bone.
“The tendons in your baby’s leg and foot are shorter and tighter than they should be. That causes the foot to twist. About half of babies with clubfoot have an issue with both feet”, the clinic said.
No fewer than 10,000 children are born with clubfoot in Nigeria annually according to a non-governmental organisation, Nigeria Clubfoot Treatment Partners.
Currently, the cause of clubfoot is unknown (idiopathic). Still, experts say it may be a combination of genetics and environment including a family history of clubfoot, smoking, alcohol intake, and certain medication during pregnancy.
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The bone specialist said parents should stop linking the birth of a child with clubfoot to a spiritual attack.
He said these myths and misconceptions, which deny a lot of children access to treatment must be jettisoned if the social stigma attached to the condition must be checked.
Ogirima, who is also the Provost, College of Health Sciences, Federal University Lokoja, Kogi State, said “In the orthopaedic ward, it is one in 10,000 live births worldwide. We have two types of clubfoot.
Giving insight into the treatment of clubfoot and why children should be presented early to orthopaedic surgeons, the don said, “In the past, a lot of procedures were done which are not necessary most of the time now, that is a surgical operation.
“Treatment nowadays is more of a non-operative approach. It just involves physical manipulation. Surgical procedure is no longer necessary.
“Treatment is easier from day one of life and the commonest treatment that we offer now which can offer up to 95 per cent correction of this idiopathic type of clubfoot is what we call the Ponseti.
“So we go by what is called the Ponseti treatment protocol which involves serial manipulation of all the components of clubfoot. After four to five weeks (sessions) of manipulations, you should be able to correct it, even the severe form.”
Ogirima expressed concern that despite increased awareness of clubfoot by orthopaedic surgeons who are now bringing the condition to the limelight, clubfoot was still associated with social stigma and myths in the country.
This, he said, often leads to late presentation of the child for treatment, stressing that late presentation increases the cost of treatment because it might involve surgical procedures.
He advised pregnant women to avoid folic deficiency as well as alcohol intake, warning that alcohol is very dangerous in pregnancy and could lead to birth defects.
“It can affect the developing child. Then they should avoid radiation exposure and avoid the use of non-prescribed drugs during the first trimester of pregnancy. Even Paracetamol should be avoided as much as possible because nobody knows which drug can cause a defect except the associations that we have seen”, he counselled.
SOURCE: Punch Healthwise
