How to tell clubfoot at birth
TWO and a half-year-old Ngabirano Nosiyota cries on the treatment bed at OURS Rehabilitation Centre in Ruharo, Mbarara.
By Abraham Ahabwe
TWO and a half-year-old Ngabirano Nosiyota cries on the treatment bed at OURS Rehabilitation Centre in Ruharo, Mbarara.
The orthopaedic officer, Steven Mbanzabugabo, is applying the sixth plaster having examined the extent of the correction efforts carried out on her clubfoot in the seven weeks since she was brought to the centre for treatment.
According to a 2003 clubfoot manual for rehabilitation workers, one in every three children born with physical disabilities has clubfoot. The manual says that Uganda registers 1,000 new cases of clubfoot annually.
Clubfoot is a congenital (present at birth) impairment where the foot or feet of the newly born child appear turned inward towards its body’s middle line.
The dorsal part of the foot touches the ground, while the sole faces inside out giving the patient great difficulty in standing or walking.
Its cause is unknown although Ivan Mubangizi, the occupational therapist at OURS says it tends to run in families.
He says that the centre receives between nine to 15 new cases monthly, most of whom are boys.
According to Dr Franseschi Fulvio of the Children’s Orthopedic Rehabilitation Unit (CORU) in Mengo Hospital, one child in every 1,500 born worldwide has clubfoot. He says the figure is higher for Uganda.
Mubangizi says parents must learn to detect clubfoot in their newborn. One way is heel emptiness.
“If you press your index finger on the heel and you can’t feel the heel bone or if you notice one big crease around the heel, seek medical advice,†he said.
According to Fulvio, it is better to treat clubfoot while the person is still an infant.
“This is when it creates perfect correlation of the foot and you won’t need surgery.â€
He says 90% of the cases treated in infancy are successful.
Fulvio says beyond one year, it becomes neglected clubfoot and will require full-fledged surgery, which leaves complications.
“After surgery, the foot will not be as flexible as it would have turned out if handled soon after birthâ€, he says. According to Mubangizi, the surgery after a year takes longer to heal. “Depending on the intensity of clubfoot, it may take four to six years to heal yet with the ponseti method (for babies below one year ) takes between three to four yearsâ€.
The Ponseti method was named after a Ugandan born Italian doctor, Ponseti Ignacio, who was the first doctor to treat clubfoot in that way.
Ponseti now works with the department of orthopaedic surgery in the University of Iowa in the US.
Although all hospitals in the country can handle clubfoot, rehabilitation centres like Katalemwa Cheshire in Mpererwe and OURS in Ruharo, Mbarara are better because they carry on the process to the end with proper follow up than in hospitals.
Rehabilitation centres also have tools like braces. “We get them from Katalemwa Cheshire home in Mpererwe, where there is a workshop,†says Mubangizi.
TWO and a half-year-old Ngabirano Nosiyota cries on the treatment bed at OURS Rehabilitation Centre in Ruharo, Mbarara.
The orthopaedic officer, Steven Mbanzabugabo, is applying the sixth plaster having examined the extent of the correction efforts carried out on her clubfoot in the seven weeks since she was brought to the centre for treatment.
According to a 2003 clubfoot manual for rehabilitation workers, one in every three children born with physical disabilities has clubfoot. The manual says that Uganda registers 1,000 new cases of clubfoot annually.
Clubfoot is a congenital (present at birth) impairment where the foot or feet of the newly born child appear turned inward towards its body’s middle line.
The dorsal part of the foot touches the ground, while the sole faces inside out giving the patient great difficulty in standing or walking.
Its cause is unknown although Ivan Mubangizi, the occupational therapist at OURS says it tends to run in families.
He says that the centre receives between nine to 15 new cases monthly, most of whom are boys.
According to Dr Franseschi Fulvio of the Children’s Orthopedic Rehabilitation Unit (CORU) in Mengo Hospital, one child in every 1,500 born worldwide has clubfoot. He says the figure is higher for Uganda.
Mubangizi says parents must learn to detect clubfoot in their newborn. One way is heel emptiness.
“If you press your index finger on the heel and you can’t feel the heel bone or if you notice one big crease around the heel, seek medical advice,†he said.
According to Fulvio, it is better to treat clubfoot while the person is still an infant.
“This is when it creates perfect correlation of the foot and you won’t need surgery.â€
He says 90% of the cases treated in infancy are successful.
Fulvio says beyond one year, it becomes neglected clubfoot and will require full-fledged surgery, which leaves complications.
“After surgery, the foot will not be as flexible as it would have turned out if handled soon after birthâ€, he says. According to Mubangizi, the surgery after a year takes longer to heal. “Depending on the intensity of clubfoot, it may take four to six years to heal yet with the ponseti method (for babies below one year ) takes between three to four yearsâ€.
The Ponseti method was named after a Ugandan born Italian doctor, Ponseti Ignacio, who was the first doctor to treat clubfoot in that way.
Ponseti now works with the department of orthopaedic surgery in the University of Iowa in the US.
Although all hospitals in the country can handle clubfoot, rehabilitation centres like Katalemwa Cheshire in Mpererwe and OURS in Ruharo, Mbarara are better because they carry on the process to the end with proper follow up than in hospitals.
Rehabilitation centres also have tools like braces. “We get them from Katalemwa Cheshire home in Mpererwe, where there is a workshop,†says Mubangizi.