Table 3 Reported Primary Outcome using the Ponseti method in sub-Saharan Africa
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% (253Â feet, 194 patients) | 3% |
Adewole 2014 [33], Nigeria | Pirani score and photograph | 100%; based on clinical judgement, Plantigrade functional foot | 5.16% (8Â feet) | 6Â 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 3Â weeks and 6Â 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 6Â months: 0.5 (0 to 0.5) | No episodes of recurrence after 6Â 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 24Â feet) 39% (41Â feet mild recurrence) | 7% (7Â feet) |
Biruk 2007 [26], Ethiopia | Harrold-Walker classification | 76.8% (63Â 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 61Â 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 |