ABSTRACT

Genu Recurvatum Congenitum in Newborns: Clinico-Pathogical Presentation, Management, Outcome, Challenges and prognostic factors
Ajiboye O. Lukman, Abdullahi B. Galadima, Nuradeen A. Aliyu, Okezie Chukwuebuka, Mukhtar Abdulazeez
Background: Genu Recurvatum Congenitum (GRC) commonly called congenital genu recurvatum (CGR) is a rare knee anomaly and usually a serious cause of concerns especially to the parents. It is usually diagnosed clinically at birth. The management may be non-operative or operative but neither of this has been reported from this area. Aim and Objectives: The aim of this study is to report our experience in management of this condition. The objectives are to: (1) examine the clinico-pathogical presentation, (2) evaluate the management and its outcome (3) examine the common challenges of management and prognostic factors. Methods: This is a prospective descriptive cross-sectional study of consecutive patients with CGR presenting to the clinic between January 2018 and December 2022. Informed consent was taken from the parents as well as ethical approval from the hospital Research and Ethical committee. The patients' socio-demographic data, clinical and pathological information including investigation findings, information of the management, outcome and challenges of the care were obtained. Treatment was serial gradual manipulation and correction with Plaster of Paris (POP) casting was changed every two weeks until correction of deformity was achieved. All the patients were followed up after POP cast discontinuation till when they are walking and the last findings were documented. Results: Thirty seven babies with 52 CGR in 21 females and 16 males (M: F of 1:1.31) who aged between 3 to 56 days at presentation (mean age 15.7 days). The CGR deformity was 59.46% in unilateral knee and bilateral in 40.54% of cases. Associated other deformity noted in some cases. An average of 4.9 casting episodes was used, ranging from 3 to 9 casts to achieve full correction. The mothers' age range is between 14 and 51 years with a mean age of 29.7 years. Associated CTEV in 17 cases (45.95%) and Syndromic in 2 cases. The challenges include long distance to access hospital for care, fund and cultural and beliefs. Conclusion: CGR is not rear, more in the females, present with spectrum of hyper-extension deformities and with excellent outcome by serial manipulation and casting. The challenges include late presentation, poverty, sociocultural beliefs and difficulty in accessing health care services. The negative prognostic factors include late presentations, associated pathology which is worse with syndromic types and poor compliance.
10.51658/ABMS.202441.14
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