[Surgery of congenital clubfoot in Don Orione, Health Center for physical handicaps of Ivory Coast (About 554 feet)].
OBJECTIVE
Treatment of congenital clubfoot improved in occidental country. We have studied the epidemiology, clinical and therapeutic aspects of this malformation in the context of Africa.


METHODS
This was a retrospective study. Two thousand five hundred and sixty-two patients were hospitalised and operated during 12 years, 362 of them were diagnosed with congenital clubfoot. This represented 14,1% of the surgical diseases, with an incidence of 30,2 cases per year. The male to female ratio was 1,6:1, and ages ranged from 4 months to 38 years old, 59% of which were less than 15 years old. Two hundred and four (56,3%) patients had bilateral disease, 93 (25,7%) had right side disease and 65 (18%) had left sided disease. Considering the classification types we noted in our patient population 82% type III, 5% type II, 3% type I and 10% were undefined.


RESULTS
Posteromedial approach describe by Codivilla was used in 45,5% of cases. Codivilla approach associated with lateral access to the foot in 44,4% of cases, with dorsal access in 2,3%. Few patients (7,8%) have had another approach. One hundred and seventeen patients received physiotherapy prior, but all the patients operated have postoperative physiotherapy while wearing orthopaedic shoes. Results obtained were: good in 510 cases (92%), quite good in 35 cases (6,3%), fairly good in 7 cases (1,3%) and mediocre in 2 cases (0,4%).


CONCLUSIONS
The surgical aspect is still only a fraction of the entire treatment. It is imperative that physiotherapy is started immediately and orthopaedic shoes be worn postoperatively.
Monsia
A
A
Centre des Handicapés Physiques de Bonoua, BP 21 Bonoua, Côte-d'Ivoire.
Fiogbé
M-A
MA
Dieth
A-G
AG
Zokou
G-H
GH
Aguéhoundé
C
C
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003025:Clubfoot / Q000145:classification / Q000453:epidemiology / Q000534:rehabilitation / Q000601:surgery*; D007560:Cote d'Ivoire; D005260:Female; D049669:History, 16th Century; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D026741:Physical Therapy Modalities; D011182:Postoperative Care; D012189:Retrospective Studies; D012775:Shoes; D016896:Treatment Outcome