The effect of severity of club foot based on pirani severity score on the clinical outcome and the foot bimalleolar angle at the end of treatment
Introduction Persistent foot adduction is one of the residual deformity encountered after clubfoot treatment. Foot bimalleolar angle (FBA) has been recently described for initial clubfoot assessment as an objective, specific and numerical way of assessing foot adduction. There are several clinica...
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| Main Author: | |
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| Format: | Thesis |
| Language: | English |
| Published: |
2021
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| Subjects: | |
| Online Access: | http://eprints.usm.my/57283/1/DR%20CHONG%20TECK%20SHIENG-24%20pages.pdf http://eprints.usm.my/57283/ |
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| Summary: | Introduction
Persistent foot adduction is one of the residual deformity encountered after clubfoot treatment.
Foot bimalleolar angle (FBA) has been recently described for initial clubfoot assessment as an
objective, specific and numerical way of assessing foot adduction. There are several clinical
and functional outcome scoring system after clubfoot treatment, but clinical outcome
assessment by Jain et al is more practical and objective. The aim of this study is to evaluate
the correlation of initial Pirani score with FBA and Jain clinical outcome in post treatment
patients.
Methodology
Foot tracings with the level of both the malleoli of children who completed Ponseti treatment
for clubfoot from January 2009 to June 2019 were taken. The anteromedial angle between the
long axis of foot and the bimalleolar plane was taken as the FBA angle. Initial Pirani severity
score was collected from patients’ medical records, and patients were graded post Ponseti
treatment according to Jain clinical outcome.
Results
Comparisons of initial Pirani score, FBA and Jain clinical outcome was done in 26 feet (16
patients). There was a moderate, significantly negative correlation(r = -0.62, p = 0.001, n= 26)
between Pirani score and FBA. A child with a unit increase of Pirani score has 2.85 odd of a
reduction in FBA. Kruskal Wallis test revealed a statistically significant relationship between
Pirani severity score and Jain clinical outcome (p=0.01) as well as a statistically significant
relationship between FBA and Jain clinical outcome (p=0.01).
Conclusion
The inital Pirani score inversely correlates with post treatment FBA. Poorer FBA and higher
initial Pirani score is associated with a tendency to have a poorer Jain clinical outcome. |
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