Post-treatment functional and social outcomes of corrective surgery for neglected clubfoot and other musculoskeletal deformities in two rural regions in Cameroon

Abstract

Childhood musculoskeletal deformities contribute to disability, stigma, school disruption, and social exclusion in low-resource settings. Evidence on broader post-treatment outcomes remains limited. This study assessed functional, psychosocial, educational, and socioeconomic outcomes among children treated for neglected clubfoot and other musculoskeletal deformities in rural Cameroon. We conducted a mixed-methods study in eight communities in Cameroon’s West and Adamawa regions. The quantitative component included a cross-sectional post-treatment survey of 194 children treated between July 2021 and June 2023, including 84 with neglected clubfoot and 110 with other musculoskeletal deformities. The survey used a study-specific, pretested questionnaire. Satisfaction was measured on a five-point Likert scale and pain using structured categorical frequency questions; other outcomes included ability to wear shoes, social and school participation, and use of livelihood support. The qualitative component comprised 16 key informant interviews and five focus group discussions with 40 participants. Quantitative data were summarized descriptively, while qualitative data were analysed thematically and integrated with survey findings. Overall, 174 participants (89.7%) were satisfied with treatment, mainly because of deformity correction (56.2%) and pain-free walking (13.44%). Overall, 73.7% reported no pain while walking, 55.7% no pain during heavy activity, and 76.8% could wear shoes of their choice. These functional improvements were reinforced by qualitative accounts describing greater mobility, independence, self-confidence, school participation, peer interaction, and reduced stigma. Among 89 livelihood-support recipients, 34.8% used support for follow-up transport; other uses included children’s basic needs (21.3%), school fees (16.9%), household food (14.6%), and small businesses (12.4%), as well as medical expenses including medication and school supplies. Qualitative findings further indicated support for medication, school supplies, food, and household economic activities. Caregivers and community stakeholders also reported improved disability awareness and social inclusion, although transport costs, long travel distances, limited physiotherapy, and gaps in follow-up remained important barriers. Corrective treatment was associated with favorable functional and social outcomes, while educational and livelihood support helped families sustain follow-up and meet broader child needs. Integrated programmes combining treatment, rehabilitation, education, psychosocial support, and targeted socioeconomic assistance may strengthen long-term outcomes for children with musculoskeletal deformities.

The authors' abstract, as published at the source. BMC Pediatrics, 2026 · DOI ↗