Can clubfoot scoring systems predict the number of casts and future recurrences in patients undergoing Ponseti method?

Abstract Background Congenital clubfoot is one of the common congenital orthopaedic deformities. Pirani and Dimeglio scoring systems are two classification systems for measuring the severity of the clubfoot. However, the relation between the initial amount of each of these scores and the treatment p...

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Main Authors: Mohammad Ali Tahririan, Mohammadreza Piri Ardakani, Sara Kheiri
Format: Article
Language:English
Published: BMC 2021-04-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:https://doi.org/10.1186/s13018-021-02261-4
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author Mohammad Ali Tahririan
Mohammadreza Piri Ardakani
Sara Kheiri
author_facet Mohammad Ali Tahririan
Mohammadreza Piri Ardakani
Sara Kheiri
author_sort Mohammad Ali Tahririan
collection DOAJ
description Abstract Background Congenital clubfoot is one of the common congenital orthopaedic deformities. Pirani and Dimeglio scoring systems are two classification systems for measuring the severity of the clubfoot. However, the relation between the initial amount of each of these scores and the treatment parameters is controversial. Methods Patients with severe and very severe idiopathic clubfoot undergoing Ponseti treatment were entered. Their initial Pirani and Dimeglio scores, the number of castings as a short-term treatment parameter, and the recurrences as a long-term parameter until the age of three were prospectively documented. Results One hundred patients (143 feet) with mean age of 9.51 ± 2.3 days including 68 males and 32 females and the mean initial Pirani score of 5.5 ± 0.5 and the mean initial Dimeglio score of 17.1 ± 1.6 were studied. The incidence of relapse was 8.4 %( n = 12). The mean initial Pirani score (P < 0.001) and the mean initial Dimeglio score (P < 0.003) of the feet with recurrence were significantly more than the non-recurrence feet. The mean number of casts in the recurrence group (7 ± 0.9) was significantly more than the feet without recurrences (6.01 ± 1.04) (P = 0.002). The ROC curve suggested the Pirani score of 5.75 and the Dimeglio score of 17.5 as the cut-off points of these scores for recurrence prediction. Conclusion In our study, Pirani and Dimeglio scores are markedly related with more number of casts and recurrence in patients with severe and very severe clubfoot. Also, we have introduced new cut-off points for both classification systems for prediction of recurrence. To the best of our knowledge, this finding has not been introduced into the English literature.
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spelling doaj.art-57f242dd52d442fcb7c31d338d3e3f6d2022-12-22T03:09:09ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-04-011611810.1186/s13018-021-02261-4Can clubfoot scoring systems predict the number of casts and future recurrences in patients undergoing Ponseti method?Mohammad Ali Tahririan0Mohammadreza Piri Ardakani1Sara Kheiri2Department of Orthopaedic Surgery, Isfahan University of Medical SciencesDepartment of Orthopaedic Surgery, Isfahan University of Medical SciencesDepartment of Orthopaedic Surgery, Isfahan University of Medical SciencesAbstract Background Congenital clubfoot is one of the common congenital orthopaedic deformities. Pirani and Dimeglio scoring systems are two classification systems for measuring the severity of the clubfoot. However, the relation between the initial amount of each of these scores and the treatment parameters is controversial. Methods Patients with severe and very severe idiopathic clubfoot undergoing Ponseti treatment were entered. Their initial Pirani and Dimeglio scores, the number of castings as a short-term treatment parameter, and the recurrences as a long-term parameter until the age of three were prospectively documented. Results One hundred patients (143 feet) with mean age of 9.51 ± 2.3 days including 68 males and 32 females and the mean initial Pirani score of 5.5 ± 0.5 and the mean initial Dimeglio score of 17.1 ± 1.6 were studied. The incidence of relapse was 8.4 %( n = 12). The mean initial Pirani score (P < 0.001) and the mean initial Dimeglio score (P < 0.003) of the feet with recurrence were significantly more than the non-recurrence feet. The mean number of casts in the recurrence group (7 ± 0.9) was significantly more than the feet without recurrences (6.01 ± 1.04) (P = 0.002). The ROC curve suggested the Pirani score of 5.75 and the Dimeglio score of 17.5 as the cut-off points of these scores for recurrence prediction. Conclusion In our study, Pirani and Dimeglio scores are markedly related with more number of casts and recurrence in patients with severe and very severe clubfoot. Also, we have introduced new cut-off points for both classification systems for prediction of recurrence. To the best of our knowledge, this finding has not been introduced into the English literature.https://doi.org/10.1186/s13018-021-02261-4ClubfootPirani scoreDimeglio scorePonseti methodRecurrenceNumber of casts
spellingShingle Mohammad Ali Tahririan
Mohammadreza Piri Ardakani
Sara Kheiri
Can clubfoot scoring systems predict the number of casts and future recurrences in patients undergoing Ponseti method?
Journal of Orthopaedic Surgery and Research
Clubfoot
Pirani score
Dimeglio score
Ponseti method
Recurrence
Number of casts
title Can clubfoot scoring systems predict the number of casts and future recurrences in patients undergoing Ponseti method?
title_full Can clubfoot scoring systems predict the number of casts and future recurrences in patients undergoing Ponseti method?
title_fullStr Can clubfoot scoring systems predict the number of casts and future recurrences in patients undergoing Ponseti method?
title_full_unstemmed Can clubfoot scoring systems predict the number of casts and future recurrences in patients undergoing Ponseti method?
title_short Can clubfoot scoring systems predict the number of casts and future recurrences in patients undergoing Ponseti method?
title_sort can clubfoot scoring systems predict the number of casts and future recurrences in patients undergoing ponseti method
topic Clubfoot
Pirani score
Dimeglio score
Ponseti method
Recurrence
Number of casts
url https://doi.org/10.1186/s13018-021-02261-4
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AT sarakheiri canclubfootscoringsystemspredictthenumberofcastsandfuturerecurrencesinpatientsundergoingponsetimethod