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General Orthopaedics

DO PONSETI PLASTERS DELAY GROSS MOTOR MILESTONES OF SOUTH AFRICAN CHILDREN TREATED FOR IDIOPATHIC CLUBFEET?

The South African Orthopaedic Association (SAAO) 59th Annual Congress



Abstract

Introduction

The Ponseti method for the treatment of idiopathic club foot is the gold standard of treatment in South Africa. A study in New York reviewed attainment of gross motor milestones (GMM) in these children and found that independent ambulation was delayed on average by 2 months compared to unaffected children.

Methods

A retrospective review of gross motor milestones was performed in patients treated at a South African clubfoot clinic. All patients were walking independently at review. Ages at attainment of motor milestones were recorded (sitting, crawling and walking independently). The World Health Organisation (WHO) published the normal range for achievement of these milestones in six regions across the world. We compared the results of our patients to the 50th percentile in that study.

Results

Results show that patients in our study sat at a mean of 5.6 (standard deviation +− 1.4) months and crawled at a mean of 8.2 (sd +− 2.6) months both equal to the WHO 50th centiles for unaffected children. Independent walking however was achieved at a mean of 14.4 (sd +−3.7) months which is 2.4 months later than the 50th centile for unaffected children in the WHO study. In the current study, 87.5% of children achieved independent walking within the acceptable norms provided by the WHO.

Conclusion

This information can be used to reassure parents that their children treated by the Ponseti method with idiopathic clubfeet will attain GMM with a delay of between two and three months before independent walking. The delay is not significant in terms of the functional outcome of these children.

NO DISCLOSURES