Minimum incidence of congenital talipes equino-varus (CTEV) and post treatment evaluation of residual deformities in a population in Zimbabwe

OBJECTIVE: To determine the minimum incidence (MI) of congenital talipes equino-varus (CTEV) in children; evaluate the association between CTEV and other congenital anomalies, and to assess the presence of residual deformities after conservative management at the physiotherapy department of Harare Central Hospital (HCH), Zimbabwe. DESIGN: A three year retrospective study. SETTING: Physiotherapy Department, HCH, Harare, Zimbabwe. SUBJECTS: Eighty-two children with CTEV who were assessed and treated at HCH Physiotherapy Department from January 1994 to December 1996. MAIN OUTCOME MEASURE: MI of club foot and degree of correction of the club foot after conservative management of the deformity by the physiotherapist. RESULTS: An MI rate of about 0.9 per 1000 was found over a three year period. It was also found that 30.5% of these children had other associated congenital abnormalities. There was no significant association between gender and severity of deformity (P = 0.326). A significant association between the severity of CTEV and the presence of other associated congenital deformities was found (P = 0.013). 91% of the feet were found to have a satisfactory result of treatment using the Wynne Davis scoring system (WDSS). 52% of the patients with residual deformity after discharge from physiotherapy presented with limitation in ankle and sub-talar movements. This study also indicated that children with grade 2 type of deformities were more likely to have other congenital abnormalities than those with grades 1 or 3. CONCLUSION: The MI of CTEV in the studied population was found to be lower than other countries. The WDSS indicated that a great majority of the feet examined scored above average score.