THE PONSETI REVOLUTION IN NIGERIA: A NARRATIVE REVIEW
Formerly Published in Vol. 12 No. 4 Jan. - Jun., 2025
Keywords:
Clubfoot, assessment, treatment, Ponseti, outcome, NigeriaAbstract
Background: Ponseti treatment of clubfoot, a nonoperative method that comprises manipulation, casting, percutaneous Achilles tenotomy and bracing up to four years of age, is the globally accepted gold standard for clubfoot treatment. Pioneered by Ignacio Ponseti in the 1940s, it has gradually replaced operative treatment. Nigeria adopted this method in 2009.
Objectives: This review seeks to determine the changing trend of clubfoot treatment in Nigeria, and to observe the reports from the different centers as regards the outcome, challenges and prospects of the Ponseti method of clubfoot treatment in Nigeria.
Methods: The study is a narrative review article. A literature search across different search engines including PubMed, Google Scholar, National Library of Medicine for Ponseti-based papers published by authors from centers in Nigeria was also done. Data from the search engines were obtained using key words such as clubfoot treatment in Nigeria, Ponseti technique and Achilles tenotomy. There was also a referral to grey literature including hospital reports and Ponseti clinics at three geopolitical areas of Nigeria.
Results: There was scanty literature on clubfoot treatment published by authors from Nigeria. There is a move from the operative treatment of clubfoot before 2009 towards the nonoperative Clubfoot treatment since the 2010s, with more orthopaedic surgeons adopting the Ponseti treatment method. The mean age of patient presentation is relatively higher, the tenotomy rate is lower and the relapse rate comparable to data from the developed countries.
Conclusions: There is a shift towards the adoption of Ponseti care in Nigeria. Ponseti treatment has a better outcome than the operative method in the treatment of clubfoot in children. Existing NGO collaborations help to scale up the uptake of the Ponseti method of clubfoot treatment. However, the literature on the subject from our clime is still scanty.
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