Assessment of Treatment Outcomes in the Management of Club foot using the Ponseti Technique: A cross-sectional study.

BACKGROUND: The Ponseti technique remains the preferred method for club foot treatment. Although measures of treatment outcomes have been well documented, there is no consensus on the determinants of those outcomes. This study aims to assess treatment outcomes and the factors which can influence treatment outcomes. MATERIALS AND METHODS: This is a cross-sectional study. A total of 472 children representing 748 feet in total were recruited. Patient characteristics such as age at presentation, gender, tenotomy, walking with or without deformity, parental educational status and occupation were documented. Outcomes of care were assessed using indictors such as parents' satisfaction with the outcome of treatment and the patients' ambulation without deformity. The relationships between the determinant factors and these outcomes were explored using multivariable binary logistic regression. RESULTS: Most of the children (69.1%) were aged below 2 years. Brace compliance was very high (89.9%). The pre-treatment average Pirani scores were 3.9 ± 1.8 and 4.3 ± 1.8 for the right and left feet, respectively. Majority (88.3%) of the children achieved ambulation without deformity, whereas most (87%) of the parents were satisfied with the treatment outcomes. In total, parental satisfaction with child's treatment outcomes was lower in parents who were not formally educated odds ratio (OR) = 0.19 (95% confidence interval [CI] 0.08-0.43), but parental satisfaction was lower if the child had higher Pirani score OR = 0.77 (95% CI 0.62-0.96). Children who had more casts applied to the affected foot were more likely to walk without deformity OR = 1.24 (95% CI 1.01-1.52). CONCLUSIONS: This study revealed that treatment outcomes in children with club foot can be determined by some sociodemographic and treatment-related factors.

The relative associations of the paediatric trauma score and revised trauma score with the severity of childhood trauma.

BACKGROUND: Children are prone to unintentional injuries and various scoring systems have been used to triage these injuries. The aim of this study is to determine the associations between paediatric trauma score (PTS), revised trauma score (RTS) and the length of hospital stay as an indicator of injury severity. METHODS: This is a descriptive cross-sectional study conducted in the University of Calabar Teaching Hospital, Calabar and National Orthopaedic Hospital, Enugu from February 2018 to March 2020. A structured questionnaire was used to collect personal, injury-specific and treatment-specific data. The relationship between PTS, RTS and the length of hospital stay was evaluated using the one-way analysis of variance (ANOVA). RESULTS: A total of 212 patients were included in the study. Majorities (129, 60%) of the injured children were male and most of the injuries were due to falls from height (54%). The mean PTS was 5.36 ± 1.9, while the mean RTS was 7.10 ± 0.9. The Pearson's product momentum correlation coefficient shows that there was weak but statistically significant correlation between the PTS and the RTS (r = 0.22, P = 0.02). The one-way ANOVA showed a statistically significant decrease in the RTS with increasing duration of hospital admission (F-statistic = 6.654, df = 3, P = 0.000). The PTS showed a less obvious decrease with no trend. CONCLUSION: In this study, the RTS showed an inverse relationship with the length of hospital stay.