Department of Orthopaedics, Jain Hospital, Gurgaon, Haryana.
Department of Orthopaedics, Government Medical College Hospital.
J Pediatr Orthop B. 2021 Sep 1;30(5):478-483. doi: 10.1097/BPB.0000000000000832.
A prospective study to find a correlation between the severity of clubfoot and the number of casts required for the correction was conducted. The relationship of early relapse with the severity of the deformity was also studied. A total of 42 infants (61 feet) with primary and idiopathic clubfeet were included in the study. Previously treated and clubfeet due to secondary causes were excluded. All clubfeet were treated by the Ponseti method, and the Pirani score, Dimeglio score and Foot Bimalleolar (FBM) angle were taken at presentation and before every casting and at 6 months of follow-up. The average age of the child at presentation was 24 days, the average initial Pirani score was 4.172, the average initial Dimeglio score was 14.36 and the average FBM angle was 63.87 degrees. The average number of corrective casts given was 5.08 (range 2-8). The regression analysis showed a low correlation between Pirani and Dimeglio scores with the number of casts. There was no correlation between FBM angle and casting. Eleven of the 61 feet had a relapse (18%). Ten of 11 relapsed feet had a midfoot Pirani score of equal to or more than 2. The regression analysis shows a low correlation between Pirani and Dimeglio scores with the number of casts. There was no correlation between FBM angle and casting. Midfoot score equal to or more than 2 is a significant risk factor for relapse.
本研究旨在探寻马蹄足畸形严重程度与矫正所需石膏固定次数之间的相关性，并分析早期复发与畸形严重程度之间的关系。共纳入 42 例（61 足）初次就诊的特发性马蹄足患儿，排除既往治疗和继发于其他原因的马蹄足。所有患儿均采用 Ponseti 方法治疗，在就诊时、每次石膏固定前及 6 个月随访时，记录 Pirani 评分、Dimeglio 评分和足二骨间角（Foot Bimalleolar，FBM）。患儿就诊时的平均年龄为 24 天，初始 Pirani 评分为 4.172，Dimeglio 评分为 14.36，FBM 角为 63.87°。平均接受矫正石膏固定 5.08 次（范围为 2-8 次）。回归分析显示，Pirani 评分和 Dimeglio 评分与石膏固定次数之间的相关性较低，FBM 角与石膏固定次数之间无相关性。61 足中 11 足复发（18%），11 例复发足中 10 例出现中跗骨 Pirani 评分≥2。回归分析显示，Pirani 评分和 Dimeglio 评分与石膏固定次数之间的相关性较低，FBM 角与石膏固定次数之间无相关性。中跗骨评分≥2 是复发的显著危险因素。
