Agarwal Anil, Shanker Mukesh
Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, 110031, India.
J Clin Orthop Trauma. 2020 Mar-Apr;11(2):232-235. doi: 10.1016/j.jcot.2019.04.011. Epub 2019 Apr 20.
We examined the correlation between initial Pirani and Dimeglio scores and their individual components to the number of casts for older clubfoot children.
Twenty seven patients (39 feet) aged 2-11 years with idiopathic clubfeet were treated using the Ponseti technique and correlation with number of corrective casts calculated. The number of cast required was counted from application of primary cast to the time of initiation of the foot abduction orthosis.
Average 8.45 ± 2.31 (range, 4-13) casts were used for treatment. A low correlation (r = 0.203) was identified when total Dimeglio score was compared with the number of casts. No correlation was identified for Pirani score (r = 0.023). Among individual components, only cavus deformity had a significant positive correlation to cast numbers.
The Pirani and Dimeglio classifications still remain the most widely practiced clubfoot severity grading systems for the older clubfoot child. However, their prognostic value to predict the total cast duration from initial severity remains questionable.
我们研究了初始的皮拉尼（Pirani）评分和迪梅廖（Dimeglio）评分及其各个组成部分与大龄马蹄内翻足患儿石膏固定次数之间的相关性。
对27例年龄在2至11岁的特发性马蹄内翻足患者（39只脚）采用庞塞蒂（Ponseti）技术进行治疗，并计算其与矫正石膏固定次数的相关性。从初次石膏固定应用到开始使用足部外展矫形器期间计算所需石膏固定的次数。
平均使用8.45±2.31（范围4 - 13）次石膏进行治疗。将迪梅廖总分与石膏固定次数进行比较时，发现相关性较低（r = 0.203）。皮拉尼评分未发现相关性（r = 0.023）。在各个组成部分中，只有高弓畸形与石膏固定次数有显著正相关。
皮拉尼和迪梅廖分类法仍然是大龄马蹄内翻足患儿中应用最广泛的马蹄内翻足严重程度分级系统。然而，它们从初始严重程度预测总石膏固定时长的预后价值仍值得怀疑。
