[Comparison of evaluation methods of the results of congenital clubfoot treatment].

INTRODUCTION

An ideal method for the assessment of the results of treatment in congenital clubfoot should take into account the morphology of the foot and its function, the personal satisfaction of the patient of his parents, interexaminer variability, and be applied for any type of treatment.

MATERIAL AND METHODS

We evaluated at- end of growth the results of treatment of 35 patients with unilateral clubfoot, and analyzed them according to 13 different rating scores already published in the literature. The material was divided in 3 groups; 15 feet having undergone multiple surgeries, 10 feet having had only one posteromedial release procedure, and 10 feet having been treated nonoperatively.

RESULTS

None of the 13 reviewed rating methods seems to be ideal. The results of treatment, for one taken foot, were often different from one method to the other.

DISCUSSION

The high number of rating scores published in literature, is the direct evidence that there is no concensus in the evaluation of the results of treatment in congenital clubfoot. A unanimous new method should be created and should fill all the prerequisites of the ideal method, described above. Some criteria are very important to consider: A iatrogenic deformity or disability, i.e. severe lateral translation of the foot, acquired convex foot, or calcaneus foot, should be severely penalized; hopping on one foot should be the test used to evaluate the strength of triceps surae muscle in children above 5 years of age ; Radiological evidence of talonavicular dislocation is a very important long term prognostic element.

CONCLUSION

A new unanimous method for the assessment of the results of clubfoot treatment is necessary. It should be simple, easy to teach, and easy to use.