Neglected Clubfoot- a Community Health Challenge in Rural Odisha, India.

Area of Science:

• Pediatric Orthopedics
• Public Health
• Surgical Rehabilitation

Background:

• Neglected clubfoot deformities present significant challenges in low and middle-income countries due to their rigidity and need for surgical correction.
• India lacks a dedicated national program for clubfoot management, leading to a high burden of disability from untreated cases.
• Untreated clubfoot is a considerable public health problem, particularly in rural populations.

Purpose of the Study:

• To analyze the effectiveness of a community-based approach using corrective rehabilitation surgery camps for neglected clubfoot.
• To evaluate the outcomes of surgical camps in remote districts for managing rigid clubfoot deformities.

Main Methods:

• Retrospective data analysis of neglected clubfoot patients undergoing corrective surgery in 13 remote districts of Odisha from February 2014 to October 2022 (excluding 2020-2021 due to COVID-19).
• Correction of 993 clubfeet in 731 children through community-based corrective camp surgery.
• Post-operative follow-up included plaster casts and orthosis until community reintegration.

Main Results:

• The study included 731 children with 993 clubfeet; 46.78% were under 5 years old.
• Male presentation (62.10%) was significantly higher than female (37.89%).
• A significant association was found between socially backward categories and the districts where children resided (p < 0.001), but not with gender distribution across districts (p = 0.676).

Conclusions:

• Camp-based surgical approaches are viable for managing neglected clubfoot in rural settings.
• Establishing standardized operating procedures for community surgical camps is crucial to minimize morbidity in children with neglected clubfoot.