Department of Orthopaedic Surgery, Isfahan University of Medical Sciences, Isfahan, Iran.
J Orthop Surg Res. 2021 Apr 5;16(1):238. doi: 10.1186/s13018-021-02261-4.
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.
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.
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.
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.
先天性马蹄内翻足是常见的先天性骨科畸形之一。皮拉尼（Pirani）和迪梅格利奥（Dimeglio）评分系统是两种用于测量马蹄内翻足严重程度的分类系统。然而，这些评分的初始分值与治疗参数之间的关系存在争议。
纳入接受潘塞蒂（Ponseti）治疗的严重和极严重特发性马蹄内翻足患者。前瞻性记录他们的初始皮拉尼（Pirani）和迪梅格利奥（Dimeglio）评分、短期治疗参数的石膏固定次数以及 3 岁前的复发情况作为长期参数。
研究共纳入 100 例（143 足）患者，平均年龄为 9.51 ± 2.3 天，包括 68 例男性和 32 例女性，平均初始皮拉尼（Pirani）评分为 5.5 ± 0.5，平均初始迪梅格利奥（Dimeglio）评分为 17.1 ± 1.6。复发率为 8.4%（n=12）。复发组的平均初始皮拉尼（Pirani）评分（P < 0.001）和平均初始迪梅格利奥（Dimeglio）评分（P < 0.003）显著高于无复发组。复发组的石膏固定次数（7 ± 0.9）明显多于无复发组（6.01 ± 1.04）（P = 0.002）。ROC 曲线提示皮拉尼（Pirani）评分为 5.75 和迪梅格利奥（Dimeglio）评分为 17.5 可作为预测复发的评分截断值。
在我们的研究中，皮拉尼（Pirani）和迪梅格利奥（Dimeglio）评分与严重和极严重马蹄内翻足患者的石膏固定次数和复发明显相关。此外，我们还为这两种分类系统引入了新的截断值来预测复发。据我们所知，这一发现尚未在英文文献中报道。
