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Does malnutrition in clubfoot patients affect Ponseti technique and its outcome?
Muhammad Muzzammil1, Ayesha Mughal2, Abdul Qadir3
1Orthopedic Surgery, Sindh Government Hospital Karachi, Karachi, Pakistan.
Insights
Malnutrition significantly impacts the success of the Ponseti method for treating clubfoot (congenital talipes equinovarus). Malnourished children require more casts and interventions, affecting treatment outcomes.
Area of Science:
- Pediatric Orthopedics
- Nutritional Science
- Global Health
Background:
- Malnutrition is a significant health issue in developing nations, particularly affecting children and increasing disease risk.
- Congenital talipes equinovarus (clubfoot) is a common congenital orthopedic condition.
- The Ponseti method is the established standard for clubfoot treatment.
Purpose of the Study:
- To investigate the prevalence of malnutrition among pediatric clubfoot patients.
- To assess the impact of nutritional status on the effectiveness of the Ponseti technique.
Main Methods:
- A cross-sectional study involving 153 clubfoot patients treated between January and December 2018.
- Nutritional status was assessed using the World Health Organization's weight-for-age index.
- Outcomes of the Ponseti technique were analyzed in relation to nutritional status.
Main Results:
- 20.6% of the 153 patients were identified as malnourished.
- Malnourished patients required a higher average number of casts (45.5%) compared to well-nourished patients (21.42%).
- A greater proportion of malnourished patients underwent Achilles tenotomy (76.4% vs. 51.8%).
Conclusions:
- Nutritional status is significantly correlated with the outcomes of the Ponseti technique for clubfoot.
- Malnutrition can influence treatment duration, the likelihood of relapse, and overall treatment failure.
Objectives:
Malnutrition is a crucial health problem predominantly in the developing countries. Malnutrition in children is one of the main risk factors for diseases and mortality. Club foot or congenital talipes equinovarus (CTEV) is the most common form of congenital orthopaedic abnormality. Over the past 20 years, the Ponseti method is considered the gold standard for the treatment of clubfoot. Our objective is to determine the prevalence of malnutrition in clubfoot patients, and its effects on the outcome of Ponseti technique in patients presenting to the Orthopaedic Clinic of tertiary care Hospital in Karachi, Pakistan.
Method:
The cross-sectional study was conducted from January to December 2018. Total 153 clubfoot patients were treated and the World Health Organization (WHO) classification of weight-for-age index was used to assess the nutritional status of patients, and its impact on outcome of Ponseti technique was recorded and analysed with a P value ≤ .05 as significant.
Results:
Of the 153 patients, 112 (79.7%) were found in good nutritional status and 42 (20.6%) were malnourished. The average number of casts per patient and patients requiring 6+ casts in the undernutrition group was higher compared with good nutrition group (45.5% vs 21.42%, respectively). The number of Achilles tenotomy performed in the undernutrition group was also higher (76.4% vs 51.8%).
Conclusion:
A significant correlation between patients' nutritional status and outcome of the Ponseti technique is found as it influences the number of casts, possible relapse and failure of treatment.
