Clubfoot: The Treatment Outcome Using Quantitative Assessment of Deformity

Rasit, Ahmad Hata; Azani, H; Zabidah, P; Merikan, A; B, Nur Alyana

doi:10.5704/moj.1211.002

Cited by 7 publications

(6 citation statements)

References 24 publications

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“…In our study, the number of boys was close to three times the number of girls, with a ratio of 2.8:1. This is contrary to local studies conducted by Boo 9 and Rasit 10 that showed equal number of patients between the two genders. However, studies from Sweden 12 and West Australia 13 reported male predominance with the ratio of 2.4 and 2.0 to 1 respectively.…”

Section: Discussioncontrasting

confidence: 96%

“…We had more right sided (71%) unilateral clubfoot. In the literature, Byron 14 and Wallander 12 reported that right unilateral clubfoot was more common, while other studies by Boo 9 and Rasit 10 reported that the left side was more commonly affected.…”

Section: Discussionmentioning

confidence: 98%

“…Some parents may refuse treatment and decide to seek traditional methods of treatment. In 1990, Boo reported an incidence of 4.5 per 1000 live births based on data from Maternity Hospital Kuala Lumpur, Malaysia 9 . More recently, Rasit reported treatment outcome of 30 children with CTEV in East Malaysia where 18 of them required surgery due to failure of non-operative treatment 10 .…”

Section: Introductionmentioning

confidence: 99%

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Pattern of Presentation and Outcome of Short-term Treatment for Idiopathic Clubfoot / CTEV with Ponseti Method

Gunalan

Mazelan

Lee

et al. 2016

MOJ

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Introduction: Congenital Talipes Equinovarus (CTEV) is a common congenital foot deformity that is associated with long term disability. Treatment with Ponseti method has been successful especially for children who present early. We conducted this study to investigate the age of presentation of children and report the early outcome.Materials: This is a retrospective study from a single institution. We included 31 patients with 45 idiopathic clubfeet and investigated problems and success rate at the end of serial casting.Results: Mean age at presentation was 4.9 months. The mean number of casting was 6 and mean duration of casting was 2.7 months. The initial success rate of 91.1%, with four feet (8.8%) diagnosed as resistant clubfoot and eventually required soft tissue surgery. With mean follow up of 14.1 months, four other feet (8.8%) developed relapse but were treated with repeat Ponseti method.Conclusion: Many CTEV patients present late for treatment. However, the Ponseti method remained effective with high initial success rate of 91.1%. Relapsed CTEV can still be treated successfully with repeat casting using the Ponseti method.

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Section: Discussioncontrasting

confidence: 96%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pattern of Presentation and Outcome of Short-term Treatment for Idiopathic Clubfoot / CTEV with Ponseti Method

Gunalan

Mazelan

Lee

et al. 2016

MOJ

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“…There was no difference in patients with LLD; however, the LLD measurement was only of the tibial length and excluded the foot vertical length. 32 One of the main questions raised by this study is whether the clubfoot is worse because of LLD or if having an LLD results in an equinus gait and increases the risk of relapse. We believe that both assumptions are likely true.…”

Section: Discussionmentioning

confidence: 94%

Clinically Detected Leg Length Discrepancy in Patients With Idiopathic Clubfoot Deformity: Prevalence and Outcomes

Addar

Bouchard

2022

Journal of Pediatric Orthopaedics

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Background: This study evaluates the prevalence and outcomes of patients with idiopathic clubfoot and clinically detected limb length discrepancy (LLD). Methods: This is a retrospective cohort study of idiopathic clubfoot patients in a Research Ethics Board–approved clubfoot registry. Patients with LLD ≥0.5 cm (LLD+) were compared with those with no or <0.5 cm LLD (LLD−). LLD was determined by documented clinical examination. Exclusion criteria included nonidiopathic clubfoot deformity, <2-year follow-up, and incomplete records. Results: Of the 300 patients included, 27 (9.0%) had an LLD, of whom 23 patients had a unilateral clubfoot deformity. The prevalence of LLD was 15.3% and 2.67% in unilateral and bilateral clubfoot patients, respectively. The mean LLD was 1.21 cm (0.5 to 3.5 cm, SD: 0.78 cm) in LLD+ patients, with a mean of 1.27 cm (SD: 0.79 cm) in unilateral clubfoot patients and 0.88 cm (SD: 0.75 cm) in bilateral patients. The total number of casts applied in LLD+ unilateral clubfoot patients was significantly higher than in LLD− unilateral patients (9.5 vs. 6.8 casts; P=0.015). The overall relapse rate in all patients was 30.3% and was significantly higher in the unilateral only LLD+ group [relative risk (RR)=2.89] and the total LLD+ patient cohort (RR=1.68). The risk of repeat casting for relapse was also higher in the unilateral LLD+ group (RR=2.45) and the total LLD+ group (RR=1.87). The risk of surgery for relapse was significantly higher in the unilateral LLD+ group for any surgery (P=0.046), and most specifically for open tendo-Achilles tenotomy (P=0.008) and tibialis anterior tendon transfer (P=0.019). There was no correlation between the severity of LLD and Pirani score at presentation. Conclusions: LLD was present in 9% of idiopathic clubfoot patients, and most were <2 cm. There is a significantly higher risk of relapse in patients with unilateral clubfoot and LLD. The risk of surgery overall was higher in all patients with a unilateral LLD. Assessment of LLD should be routinely performed in clubfoot patients. Level of Evidence: Level III.

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“…14 Rasit et al used Quantitative Clubfoot Assessment of Deformity (QCAD) for assessing outcomes of clubfoot treatment based on Pirani deformity severity score and anthropometric measurement includes leg length, mid-leg circumference, foot length and mid-foot circumference. 15 The Bangla Tool, developed in Bangladesh, evaluated results of clubfoot management as a tool that was quick, relevant and reliable for use in children of walking age who present to clubfoot clinics. 16 Three areas of examination are included: parent satisfaction, gait, clinical examination of the clubfoot.…”

Section: Discussionmentioning

confidence: 99%

Nwdps protocol - A simple functional outcome assessment tool for clubfoot correction and a review of literature

Agarwal

Gupta

Agarwal

2020

Journal of Clinical Orthopaedics and Trauma

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Introduction: Various clubfoot severity scoring systems are known to us. Dimeglio and Pirani Scoring systems are most widely used. Also, various treatment outcome measures have been proposed by researchers to assess patient satisfaction and results of treatment. None of the available methods are widely popular and amenable for routine use. A "nwdps protocol" was proposed for functional assessment of patients with clubfoot correction, where "n" was no pain during walking or running; "w" was ability to wear normal shoes; "d" was no significant difference in foot/shoe size of both sides; "p" was plantigrade foot and "s" was ability of the child to squat without heel lift-off. The aim of this study was to test this functional outcome assessment tool for easy day to day use post clubfoot correction. Methods: The nwdps protocol was applied to all the children at followup on a yearly basis who underwent clubfoot deformity correction in Department of Orthopaedics of our Institute between March 2016 and January 2018. Results: Eighty children were enrolled for the study, 45 had bilateral affection while 35 had unilateral affection. In all 125 feet were treated for clubfoot correction and evaluated using nwdps protocol. Each child was assessed by 2 researchers independently. There was no difference in functional assessment of 2 observers. Fifty-nine children were nwdp positive, one was nwps positive, while 2 were dwps positive at the end of 1 year. 79 children became nwdps positive at the end of 2nd year of followup. Conclusion: Nwdps protocol is a very easy to remember and easy to use functional outcome assessment tool post clubfoot correction with high degree of objectivity and interobserver reliability. Level of evidence: Level IV.

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Clubfoot: The Treatment Outcome Using Quantitative Assessment of Deformity

Abstract: Clubfoot, outcome, treatment, quantitative assessment, deformity.

Cited by 7 publications

References 24 publications

Pattern of Presentation and Outcome of Short-term Treatment for Idiopathic Clubfoot / CTEV with Ponseti Method

Pattern of Presentation and Outcome of Short-term Treatment for Idiopathic Clubfoot / CTEV with Ponseti Method

Clinically Detected Leg Length Discrepancy in Patients With Idiopathic Clubfoot Deformity: Prevalence and Outcomes

Nwdps protocol - A simple functional outcome assessment tool for clubfoot correction and a review of literature

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