Clubfoot Care in Low-Income and Middle-Income Countries: From Clinical Innovation to a Public Health Program

@article{Harmer2013ClubfootCI,
  title={Clubfoot Care in Low-Income and Middle-Income Countries: From Clinical Innovation to a Public Health Program},
  author={Luke S Harmer and Joseph J. Rhatigan},
  journal={World Journal of Surgery},
  year={2013},
  volume={38},
  pages={839-848}
}
BackgroundClubfoot occurs in nearly 1 in every 1,000 live births worldwide, representing a significant burden of disease. In high-income countries, an evidence-based treatment protocol utilizing sequential casting was pioneered by Ponseti and has resulted in excellent outcomes among children treated for this condition. However, treatment methods and results of treatment vary greatly across low- and middle-income countries (LMICs). Our goal was to create a framework for understanding how… 

What factors impact on the implementation of clubfoot treatment services in low and middle-income countries?: a narrative synthesis of existing qualitative studies

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It is concluded that more efforts need to be done for the diagnosis and treatment of children with clubfeet, including actions which are focused on raising awareness around this abnormality and more well-developed treatment guidelines.

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Relapse occurred in 15/72 drop out cases, predicted by problems with casting and predicted worse foot posture and reduced physical functioning, and probably lowering the overall relapse rate with inclusion of ‘postural’ cases.

Diagnosis and Treatment of Idiopathic Congenital Clubfoot.

An important factor in the ultimate success of the Ponseti method is parental understanding of the bracing phase, and there is a very high rate of recurrent deformity when bracing is not done properly or is stopped prematurely.

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It is recommended that clubfoot is ideally treated within the age bracket of 0-6 months to prevent relapse, increased duration of treatment and too much serial casting and also promote a society with reduced rate of clubfoot deformity, thereby reducing need for future bone correction surgery, and reduced direct effects of late management of club foot on the child’s family.

Oral Sucrose for Pain Relief During Clubfoot Casting: A Double-Blinded Randomized Controlled Trial

Sucrose solution and milk during Ponseti casting and manipulation were effective in decreasing the pain response in children undergoing manipulation and casting for clubfeet.

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