Determining Reasons Affecting the Late Treatment of Congenital Talipes Equinovarus: A Qualitative Study

BACKGROUND: Neglected congenital talipes equinovarus (CTEV) is a serious problem commonly found in developing countries. This deformity has fatal impacts, including disabilities and educational limitations. Moreover, cases of neglected CTEV are still frequent in Indonesia as one of the developing countries. Thus, this study aims to investigate the reasons behind the late treatment of CTEV. METHODS: This is a qualitative study conducted throughout September 2019. The subjects are six parents of patients with neglected CTEV who are currently being treated in our hospital. The study was conducted by performing an in-depth interview with the patient’s parents to analyze why they delay checking their child to an orthopaedic surgeon. The results were then grouped into themes. RESULTS: The reasons for the delay were multifactorial. Four subjects had more than one reason why they delayed checking their child to an orthopaedic surgeon. The reason for the delay were socioeconomic factors (3 subjects), medical-related problems (3 subjects), intentionally delayed or refused to seek medical care (2 subjects), and misinformation from the previous physician (3 subjects). CONCLUSIONS: The reasons for the late treatment of CTEV were socioeconomic factors, medical-related problems, intentional factors, and misinformation.

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Surgical outcome with single stage procedure for neglected congenital talipes equinovarus

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20195564 ◽

2019 ◽

Vol 6 (1) ◽

pp. 37

Author(s):

Vishal H. Chandak ◽

Ketan J. Khatri ◽

Shraddha H. Chandak

Keyword(s):

Developing Countries ◽

Soft Tissue ◽

Single Stage ◽

High Rate ◽

Prolonged Treatment ◽

Soft Tissue Release ◽

Wedge Osteotomy ◽

Congenital Talipes Equinovarus ◽

Talipes Equinovarus ◽

Congenital Talipes

Background: Congenital talipes equinovarus is one of the commonest congenital anomalies. In developing countries like India especially in the rural population still there are many myths, culture and awareness issues regarding this deformity. Many patients get initial treatment with casting but tend loose follow ups in this prolonged treatment. To give optimal results in these scenarios, the technique for single stage procedure which includes bony and soft tissue repair gives excellent results.Methods: In a retrospective longitudinal study, 13 children with neglected clubfeet were involved. Valid consent, clinical and radiological evaluation was done. Patients underwent single stage (bony and soft tissue) procedure described in the study. Post operatively data was collected and scoring was done as per International clubfoot study group (ICSG) at each follow ups.Results: A total 13 children out of whom 9 were male and 4 females, all having unilateral deformity were studied. The age group was between 5-22 years (mean 13.5). Postoperatively, the children were followed at 6 months intervals. As per ICSG score 10 patients had excellent results, 3 patients had good results and none had poor results. 2 patients had minor complication - delayed wound healing (2-3 weeks).Conclusions: Treatment of neglected clubfoot using single stage procedure dorsal close wedge osteotomy with soft tissue release has a high rate of good and excellent results, with low frequency of complications. It is a good alternative to conventional procedures for management of neglected clubfeet in developing countries, where compliance of patient is a problem.

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