Evaluating Nutritional and Clinical Correlates of Ponseti Technique Success in Pediatric Clubfoot.

Abstract

Malnutrition is a very critical health problem, especially among developing countries. It is considered one of the major risk factors for diseases and mortality in children. Clubfoot or congenital talipes equinovarus (CTEV) is the most common form of congenital orthopedic abnormality, and the Ponseti method has become the gold standard of treatment for clubfoot over the last two decades. This research study aimed at identifying the malnutrition prevalence in clubfoot patients and its relation with the Ponseti technique's outcome for the patients coming to the Orthopedic Clinic of a tertiary care hospital in Karachi, Pakistan. We further attempted to investigate the relationship of the clinical tests between CBC, serum albumin level, serum electrolytes, and nutritional status. This was a cross-sectional study carried out from January to December 2022 with a total of 105 clubfoot patients. The WHO classification of weight-for-age index was used to assess the nutritional status of patients, and clinical tests were also conducted to evaluate the correlation between malnutrition and the outcome of the Ponseti technique. Statistical analysis was performed with a P value ≤ 0.05 deemed significant. Among 105 patients, 84 (80%) had good nutritional status and 21 (20%) had malnutrition. The average number of casts per patient and the percentage of patients requiring 6 or more casts were higher in the malnourished group at 45.5% compared to 21.42%. The number of Achilles tenotomy procedures performed was higher in the malnourished group at 76.4% compared to 51.8%. Clinical tests proved a straight correlation of nutritional status and results after the Ponseti technique. Malnutrition remains a critical determinant of Ponseti technique outcomes in clubfoot patients. Addressing nutritional deficits through early interventions and incorporating clinical tests into routine evaluations can significantly improve treatment efficacy. These findings highlight a strong correlation between malnutrition and increased treatment complexity, but causality cannot be concluded from this study. Further longitudinal or interventional research is warranted to explore these relationships more definitively.