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Table 3 Reported Primary Outcome using the Ponseti method in sub-Saharan Africa

From: Assessment of success of the Ponseti method of clubfoot management in sub-Saharan Africa: a systematic review

Primary Author Year Country* Clubfoot severity assessment Reported Success Measure Recurrence / relapse Additional surgical intervention
Ibraheem 2017 [21], Nigeria Pirani score Number of days in casts, number of casts applied Not reported Not reported
Malagelada 2016 [32], South Africa Pirani score Parent reported outcomes 12% (8 children) Not reported
Smythe 2016 [35], Zimbabwe Pirani Score 85% feet; Pirani score < 1 Not reported Not reported
Boakye 2016 [38], Ghana Pirani Score Number of casts to correction. Correction not defined. Not reported Not reported
Adegbehingbe 2015 [39], Nigeria Not reported 89.7% (4426 patients) satisfactory outcome. Criteria for satisfactory outcome not defined. 4% (253 feet, 194 patients) 3%
Adewole 2014 [33], Nigeria Pirani score and photograph 100%; based on clinical judgement, Plantigrade functional foot 5.16% (8 feet) 6 feet
Ayana 2014 [24], Ethiopia Pirani score 28/41 good results Good = correction of all deformities. 97.8% achieved score of <3 2 patients, 4 feet 8 children/ (11 feet)
Kouamo 2014 [40], Togo Not reported 94% (179/190) compliant with brace wear 93.5% no visible discomfort 12.2% (5 cases) Not reported
Mang’oli 2014 , Kenya Pirani score Initial correction: 96.2% (152 feet) Initial correction not defined. Not reported Not reported
Kaseke 2013 [41], Zimbabwe Pirani score Rate of correction: Pirani score at 3 weeks and 6 weeks Not reported Not reported
Adegbehingbe 2012 [42], Nigeria Pirani Score 89.7% treated successfully. Criteria for success not defined. Not reported 3.2% (16 patients)
Cashman 2012 [20], Malawi Not reported 30 children failed treatment (required more extensive surgery) Not reported 30 children
Pirani 2012 [43], Uganda Pirani Score Mean score 5.4 falls to <2 by cast 6. Primary outcome not defined. Not reported Not reported
Harnett 2011 [44], Malawi Pirani Score Pirani score change. Median start Pirani: 5 (4 to 6). Median at tenotomy /end treatment: 0.5 (0.5 to 1) Median at 6 months: 0.5 (0 to 0.5) No episodes of recurrence after 6 months 3 patients not corrected (7%) with Pirani >1
Adegbehingbe 2010 [25], Nigeria Dimeglio classification 96.4% (53/55 children) = satisfactory (No recurrence) 3.6% (2/55) = fair (recurrence corrected with casts/FAB) Nil = poor (recurrence with repeat surgery) 2 had recurrence between 4 and 6 months None
Radler 2010 [45], Mali Not reported 77% (40 children): good or average. 23% (12 children): poor. Primary outcome not defined. Not reported Not reported
Firth 2009 [30], South Africa Pirani score 61% fully corrected without residual deformity 23% (re-plaster 24 feet) 39% (41 feet mild recurrence) 7% (7 feet)
Biruk 2007 [26], Ethiopia Harrold-Walker classification 76.8% (63 feet) No definition of complete correction. Not reported Not reported for Ponseti cohort
Lavy 2007 [28], Malawi Pirani score 68% (327/482) Plantigrade or better Not reported 12 children referred for surgery
Khan 2005 [27], South Africa Harrold-Walker classification 6 failures from 61 feet. Criteria for success not defined. Not reported Not reported
Tindall 2005 [29], Malawi Pirani score 98% plantigrade foot with Pirani score Not reported 2%
Mkandawire 2003 [36], Malawi Pirani score Correction of deformity. Success of correction defined as fitting brace. Mean Pirani score decreased from 3.6–0.86 4 children with untreated clubfoot, 5 with complex and 7 with teratologic Not reported
  1. *Ordered by year of publication