Surgical Treatment Functional Outcome of Delayed Clubfoot in Tibebe Gihon Specialized Hospital from June 2022- June 2023: Case Series Study

Abstract

Idiopathic clubfoot occurs in approximately 1 in 1,000 live births, with most cases (80–91%) found in low- and middle-income countries (LMICs). Due to limited access to early treatment, many children present with delayed or neglected deformities. However, surgical outcomes for this population remain underexplored, particularly in Ethiopia. This study evaluates functional outcomes following surgical correction of delayed clubfoot at Tibebe Ghion Specialized Hospital. A case series was conducted from June 2022 to June 2023, including patients aged over 2 years who underwent soft-tissue release, tibialis anterior tendon transfer (TATT), or triple arthrodesis. Data were collected through chart review, physical examination, and a pretested questionnaire. Functional outcomes were assessed using the Laaveg-Ponseti scoring system. A total of 30 patients (36 feet) with a mean age of 10.53 years (range: 2–22) were included. Mean follow-up was 18.6 months. Postoperative Laaveg-Ponseti scores averaged 83.7%, with 40% excellent, 20% good, 33.3% fair, and 6.7% poor results. All patients achieved independent shoe wear. Younger age at surgery was significantly associated with better outcomes (p < 0.05). Surgical intervention for neglected clubfoot with severe deformity produced satisfactory functional and cosmetic results. Early treatment remains essential. These findings address a critical evidence gap and support the development of standardized surgical protocols in resource-limited settings.