Chen Yungu, Cao Shengxuan, Wang Chen, Ma Xin, Wang Xu
Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China.
Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China.
J Foot Ankle Surg. 2023 Mar-Apr;62(2):218-221. doi: 10.1053/j.jfas.2022.06.011. Epub 2022 Jun 30.
Although Dimeglio and Pirani scores are frequently employed to rate the severities of clubfoot and to evaluate treatment outcomes, it is unclear if these scores predict relapse after treatment. Ankle dorsiflexion has been suggested in recent years to be a promising predictor of relapse. The aim of this study was to investigate ankle dorsiflexion and Dimeglio and Pirani scores in predicting the relapse of clubfoot after treatment with the Ponseti method. We included patients with clubfoot previously treated by the Ponseti method, and retrospectively analyzed their initial ankle dorsiflexion, Pirani and Dimeglio scores, number of castings, and the occurrence of relapse. We analyzed 218 feet of 176 infants with clubfoot who showed an incidence of relapse of 17.0% (30/176). The mean initial Pirani and Dimeglio scores of the feet showing recurrence were significantly higher than individuals with non-recurrence (p < .001 each). We observed a robust association between Pirani and Dimeglio scores and the recurrence of clubfoot at the last follow-up (γ = 0.53, p = .001). In contrast, ankle dorsiflexion was negatively correlated with recurrence of clubfoot (γ = -0.21, p = .001). Dimeglio scores significantly predicted the recurrence of clubfoot (p = .014). Receiver operating characteristic curve analysis exhibited slightly better performance regarding the Dimeglio score relative to the Pirani score and ankle dorsiflexion in predicting recurrence. Ankle dorsiflexion and Pirani and Dimeglio scores were related to recurrence in patients with clubfoot. However, the Dimeglio score reflected superior accuracy in predicting the prognosis of clubfoot treated with the Ponseti method.
尽管迪梅廖（Dimeglio）评分和皮拉尼（Pirani）评分经常用于评估马蹄内翻足的严重程度和治疗效果，但这些评分能否预测治疗后的复发尚不清楚。近年来，踝关节背屈被认为是复发的一个有前景的预测指标。本研究的目的是探讨踝关节背屈以及迪梅廖评分和皮拉尼评分在预测经庞塞蒂（Ponseti）方法治疗后马蹄内翻足复发中的作用。我们纳入了先前接受过庞塞蒂方法治疗的马蹄内翻足患者，并回顾性分析了他们最初的踝关节背屈、皮拉尼评分和迪梅廖评分、石膏固定次数以及复发情况。我们分析了176例马蹄内翻足婴儿的218只脚，复发率为17.0%（30/176）。出现复发的足部的平均初始皮拉尼评分和迪梅廖评分显著高于未复发的个体（均p < 0.001）。我们观察到皮拉尼评分和迪梅廖评分与最后一次随访时马蹄内翻足的复发之间存在强关联（γ = 0.53，p = 0.001）。相比之下，踝关节背屈与马蹄内翻足的复发呈负相关（γ = -0.21，p = 0.001）。迪梅廖评分显著预测了马蹄内翻足的复发（p = 0.014）。受试者工作特征曲线分析显示，在预测复发方面，迪梅廖评分相对于皮拉尼评分和踝关节背屈表现略优。踝关节背屈以及皮拉尼评分和迪梅廖评分与马蹄内翻足患者的复发有关。然而，迪梅廖评分在预测经庞塞蒂方法治疗的马蹄内翻足预后方面表现出更高的准确性。
