Characterization of patients with congenital talipes equinovarus treated between 2016 and 2021 in a hospital in the department of Tolima, Colombia
DOI:
https://doi.org/10.58814/01208845.69Keywords:
Foot Diseases, Clubfoot, Foot Deformities, Congenital, OrthopedicsAbstract
Introduction: Congenital talipes equinovarus (CTEV), also known as clubfoot, is the most common musculoskeletal deformity of the foot. In Colombia, despite being the second most frequent congenital malformation, the characterization of the local population is not fully documented.
Objective: To describe the clinical and sociodemographic characteristics of pediatric patients with CTEV treated at a tertiary care hospital in Tolima, Colombia.
Methodology: Cross-sectional descriptive study conducted in 91 pediatric patients (0 months-17 years) with CTEV treated between 2016 and 2021 by the outpatient orthopedics and trauma service of the Hospital Federico Lleras Acosta in Ibagué, Colombia.
Results: The mean age of the patients at the time of initial assessment was 3.8 years (±3.1), 60.4% (n=55) were male, and 57.14% resided in Ibagué. There was a higher proportion of patients with idiopathic CTEV (82.4%; n=75) and bilateral involvement (51.6%; n=47), as well as greater involvement of the left foot (52.2%, n=23) in individuals with unilateral involvement (n=44). Moreover, 26 comorbidities were found in 20 patients (14 with one comorbidity and 6 with 2 comorbidities), the most frequent being cerebral palsy (40%, n=8). All patients were treated using the Ponseti Method (average number of casts: 5.5).
Conclusions: The characteristics of the patients included in the present study are similar to those reported in the literature in terms of sex, type of CTEV, frequency of bilateral involvement, and presence of comorbidities. Considering the average age at the time of treatment initiation, it is recommended to have these patients evaluated by an orthopedic specialist earlier.
Downloads
References
Rieger MA, Dobbs MB. Clubfoot. Clin Podiatr Med Surg.2022;39(1):1-14. https://doi.org/mtjk.
Naranjo Morales B. Eficacia del método Ponseti en el tratamiento del pie equinovaro. Rev Int Cienc Podol. 2019;13(2):99-113. https://doi.org/mtjn.
Bossio JE, González A, Cuenca JF, Herrera G, Morcuende JA, Sepúlveda-Arriagada D. Etiología y anatomía patológica del pie equino varo congénito idiopático. Revisión de conceptos actuales. Rev Colomb Ortop Traumatol. 2021;35:3-9. https://doi.org/mtjp.
Cock PR, Suárez JA, Rodríguez S. Resultados del tratamiento de pie equinovaro congénito con el método de Ponseti. Rev Colomb Ortop Traumatol. 2018;32(2):134-40. https://doi.org/kdq8.
Ferrando Meseguer E, Roig Sánchez S, Pino Almero L, Romano Bataller A, Mínguez Rey MF. Pie zambo sindrómico más allá de la artrogriposis y el mielomeningocele: tratamiento ortopédico con el método de Ponseti. Rev Esp Cir Ortop Traumatol. 2021;65(3):180-5. https://doi.org/kgk6.
Acosta-Murcia MM, Holguín-Prieto JP, Satizábal A, Uribe-Rios A, Trujillo-González CI, Morcuende JA. Tratamiento del pie equino varo asociado a síndromes. Revisión de conceptos actuales. Rev Colomb Ortop Traumatol. 2021;35:44-53. https://doi.org/mtjq.
Rueda-Leguisamo KK, Aldaz-Santamaria MP. Pie equinovaro congénito tratamiento y pronostico actual. MQRInvestigar. 2023;7(2):1652-65. https://doi.org/mtjr.
Zarante I, Franco L, López C, Fernández N. Frecuencia de malformaciones congénitas: evaluación y pronóstico de 52.744 nacimientos en tres ciudades colombianas. Biomedica. 2010;30(1):65-71. https://doi.org/b4sm.
Apostle KL, Sangeorzan BJ. Anatomy of the varus foot and ankle. Foot Ankle Clin. 2012;17(1):1-11. https://doi.org/fzgc8m.
Birrer E, Morovic M, Fernández P. PIE BOT: CONCEPTOS ACTUALES. Rev médica Clín Las Condes. 2021;32(3):344-52. https://doi.org/g8zh.
Alves A, Bismuth Y, Vialle R. Anomalías de los pies en el nacimiento. EMC - Tratado de Medicina. 2024;28(2):1-10. https://doi.org/mtpd.
Grimes CE, Holmer H, Maraka J, Ayana B, Hansen L, Lavy CBD. Cost-effectiveness of club-foot treatment in low-income and middle-income countries by the Ponseti method. BMJ Glob Health. 2016;1(1):e000023. https://doi.org/gjcn8f.
Balasankar G, Luximon A, Al-Jumaily A. Current conservative management and classification of club foot: A review. J Pediatr Rehabil Med. 2016;9(4):257-64. https://doi.org/mtpf.
Rani M, Kumari P. Congenital clubfoot: A comprehensive review. Orthop Rheumatol Open Access J. 2017;8(1):555728. https://doi.org/mtpg.
Pavone V, Chisari E, Vescio A, Lucenti L, Sessa G, Testa G. The etiology of idiopathic congenital talipes equinovarus: a systematic review. J Orthop Surg Res. 2018;13(1):206. https://doi.org/gd468z.
Shyy W, Dietz F, Dobbs MB, Sheffield VC, Morcuende JA. Evaluation of CAND2 and WNT7a as candidate genes for congenital idiopathic clubfoot. Clin Orthop Relat Res. 2009;467(5):1201-5. https://doi.org/ddr4ck.
Chen C, Kaushal N, Scher DM, Doyle SM, Blanco JS, Dodwell ER. Clubfoot etiology: A meta-analysis and systematic review of observational and randomized trials. J Pediatr Orthop. 2018;38(8):e462-9. https://doi.org/gd5qf6.
Ortiz-Montoya DF, Posada A, Quesada-Aguilar M P, García JR, Morcuende JA, Nogueira MP. Pie equino varo congénito no tratado en el paciente escolar, adolescente y adulto. Revisión de conceptos actuales. Rev Colomb Ortop Traumatol. 2021;35:54-61. https://doi.org/mtph.
Werler MM, Yazdy MM, Mitchell AA, Meyer RE, Druschel CM, Anderka M, et al. Descriptive epidemiology of idiopathic clubfoot. Am J Med Genet A. 2013;161A(7):1569-78. https://doi.org/f98qnx.
Shah MQ, Khan A, Zardad MS, Iqbal R, Ahmed S. Ponseti technique for management of congenital idiopathic club foot. J Ayub Med Coll Abbottabad. 2017;29(2):246-9.
Saqib, Soomro S, Shaikh AA, Shuaib M, Sarwar G, Soomro ZA. Effectiveness of Ponseti Technique in treatment of idiopathic clubfoot in age of 2 to 5 years. Pakistan Journal of Medical and Health Sciences. 2022;16(1):601-3. https://doi.org/mtpj.
Owen RM, Kembhavi G. A critical review of interventions for clubfoot in low and middle-income countries: Effectiveness and contextual influences. J Pediatr Orthop B. 2012;21(1):59-67. https://doi.org/cphz8m.
Global Clubfoot Initiative. La erradicación de la discapacidad por Pie Equinovaro: Una estrategia mundial. UK: 2017 [cited 2023 Oct 29]. Available from: https://bit.ly/3Cl6xOq.
Pietrucin-Materek M, van Teijlingen ER, Barker S, Forrest Keenan K, Miedzybrodzka Z. Parenting a child with clubfoot: A qualitative study. Int J Orthop Trauma Nurs. 2011;15(4):176-84. https://doi.org/ds4cw8.
Mayne AI, Bidwai AS, Beirne P, Garg NK, Bruce CE. The effect of a dedicated Ponseti service on the outcome of idiopathic clubfoot treatment. Bone Joint J. 2014;96-B(10):1424-6. https://doi.org/m4qx.
World Medical Association (WMA). WMA Declaration of Helsinki – Ethical principles for medical research involving human subjects. Fortaleza: 64th WMA General Assembly; 2013.
Colombia. Ministerio de Salud. Resolución 8430 de 1993 (octubre 4): Por la cual se establecen las normas científicas, técnicas y administrativas para la investigación en salud. Bogotá D.C.; octubre 4 de 1993 [cited 2023 Aug 31]. Available from: https://bit.ly/31gu7do.
Cady R, Hennessey TA, Schwend RM. Diagnosis and treatment of idiopathic congenital clubfoot. Pediatrics. 2022;149(2):e2021055555. https://doi.org/mtpk.
Dobbs MB, Gurnett CA. Update on clubfoot: Etiology and treatment. Clin Orthop Relat Res. 2009;467(5):1146-53. https://doi.org/ccw9qx.
Nielsen MF, Møller-Madsen B, Engell V. Behandling af klumpfødder hos børn [Treatment of clubfoot in children]. Ugeskr Laeger. 2022;184(40):V04220238.
Esbjörnsson A-C, Johansson A, Andriesse H, Wallander H. Epidemiology of clubfoot in Sweden from 2016 to 2019: A national register study. PLoS One]. 2021;16(12):e0260336. https://doi.org/gnpgpt.
Rosselli P, Nossa S, Huérfano E, Betancur G, Guzmán Y, Castellanos C, et al. Prenatal ultrasound diagnosis of congenital Talipes Equinovarus in Bogota (Colombia) between 2003 and 2012. Iowa Orthop J. 2015;35:156-9.
Brasseur-Daudruy M, Abu Amara S, Ickowicz-Onnient V, Touleimat S, Verspyck E. Clubfoot versus positional foot deformities on prenatal ultrasound imaging. J Ultrasound Med. 2020;39(3):615-23. https://doi.org/mtpr.
Santa A, Becerra LC, Céspedes LJ, Rosselli P, Morcuende JA. Tratamiento del pie equino varo congénito idiopático. Revisión de Conceptos Actuales. Rev Colomb Ortop Traumatol. 2021;35(Suppl 1):10-20. https://doi.org/mtps.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Revista Colombiana de ortopedia y traumatología
This work is licensed under a Creative Commons Attribution 3.0 Unported License.
