Description
This presentation by Dr. Kyle James focuses on the management and treatment of clubfoot in older children, drawing from his experience in Malawi. He discusses the challenges faced by children born with clubfoot, particularly in low- to middle-income countries where access to effective treatments is severely limited. Dr. James emphasizes the importance of early treatment utilizing the Ponseti method, which is effective yet under-utilized, with only a small percentage of children receiving timely care.
He introduces various assessment techniques, such as the Paver score developed by Tim Nunn, which helps predict the likelihood of correction through casting. The presentation details the casting process, highlighting the necessity for multiple casts, modifications for older children, and the importance of monitoring for pain and pressure sores.
Surgical interventions are discussed as alternatives, including tenotomies and the use of corrective frames for more severe cases. Dr. James explains the specifics of implementing an Ilizarov frame for rigid clubfeet, detailing the procedure, setup, and the step-by-step approach to osteotomy techniques. He underscores the resource-intensive nature of both casting and surgical methods and the necessity of trained personnel to achieve successful outcomes.
Ultimately, the presentation stresses the need for comprehensive and timely treatment for clubfoot to prevent complications and relapse in function. Dr. James concludes by reinforcing the priority of early intervention with the Ponseti method, which has demonstrated higher success rates than corrective measures taken later.