Agarwal Ankur, Gupta Sumit, Agarwal Sheetal
Department of Orthopaedics, Superspecialty Pediatric Hospital & Postgraduate Teaching Institute, Sector 30, Noida, 201303, India.
Department of Orthopaedics, Lady Hardinge Medical College & Associated Kalawati Saran Children's Hospital, New Delhi, 110001, India.
J Clin Orthop Trauma. 2020 Mar-Apr;11(2):236-239. doi: 10.1016/j.jcot.2019.05.006. Epub 2019 May 8.
Various clubfoot severity scoring systems are known to us. Dimeglio and Pirani Scoring systems are most widely used. Also, various treatment outcome measures have been proposed by researchers to assess patient satisfaction and results of treatment. None of the available methods are widely popular and amenable for routine use. A "nwdps protocol" was proposed for functional assessment of patients with clubfoot correction, where "n" was o pain during walking or running; "w" was ability to ear normal shoes; "d" was no significant ifference in foot/shoe size of both sides; "p" was lantigrade foot and "s" was ability of the child to quat without heel lift-off. The aim of this study was to test this functional outcome assessment tool for easy day to day use post clubfoot correction.
The nwdps protocol was applied to all the children at followup on a yearly basis who underwent clubfoot deformity correction in Department of Orthopaedics of our Institute between March 2016 and January 2018.
Eighty children were enrolled for the study, 45 had bilateral affection while 35 had unilateral affection. In all 125 feet were treated for clubfoot correction and evaluated using nwdps protocol. Each child was assessed by 2 researchers independently. There was no difference in functional assessment of 2 observers. Fifty-nine children were nwdp positive, one was nwps positive, while 2 were dwps positive at the end of 1 year. 79 children became nwdps positive at the end of 2nd year of followup.
Nwdps protocol is a very easy to remember and easy to use functional outcome assessment tool post clubfoot correction with high degree of objectivity and interobserver reliability.
Level IV.
我们了解多种马蹄内翻足严重程度评分系统。迪梅吉奥（Dimeglio）评分系统和皮拉尼（Pirani）评分系统应用最为广泛。此外，研究人员还提出了各种治疗效果评估方法，以评估患者满意度和治疗结果。现有的方法都未广泛流行且不适用于常规使用。有人提出了一种“nwdps方案”用于马蹄内翻足矫正患者的功能评估，其中“n”代表行走或跑步时无疼痛；“w”代表能够穿正常鞋子；“d”代表双侧足/鞋尺寸无显著差异；“p”代表直立足，“s”代表儿童无需踮脚跟就能蹲下的能力。本研究的目的是测试这种功能结局评估工具，以便在马蹄内翻足矫正后便于日常使用。
2016年3月至2018年1月期间，在我院骨科接受马蹄内翻足畸形矫正的所有儿童在每年随访时均应用nwdps方案。
80名儿童纳入研究，45名双侧受累，35名单侧受累。总共125只足接受了马蹄内翻足矫正治疗，并使用nwdps方案进行评估。每个儿童由2名研究人员独立评估。2名观察者的功能评估无差异。1年后，59名儿童nwdp阳性，1名nwps阳性，2名dwps阳性。随访第2年末，79名儿童nwdps阳性。
Nwdps方案是一种非常易于记忆和使用的马蹄内翻足矫正后功能结局评估工具，具有高度的客观性和观察者间可靠性。
四级。
