Interobserver Reliability of Pirani and Dimeglio Scores in the Clinical Evaluation of Idiopathic Congenital Clubfoot

Abstract

Background: Dimeglio (DimS) and Pirani (PirS) scores are the most common scores used in congenital talipes equinovarus (CTEV) clinical practice. The aim of this study was to evaluate the interobserver reliability of these scores and how clinical practice can influence the clinical outcome of clubfoot through the DimS and Pirs. Methods: Fifty-four feet were assessed by six trained independent observers through the DimS and PirS: three consultants (OS), and three residents (RS) divided into three pediatric orthopaedic surgeons (PeO) and three non-pediatric orthopaedic surgeons (NPeO). Results: The PirS and DimS Scores were strongly correlated. In the same way, OS and RS, PirS, and DimS scores were strongly correlated, and the interobserver reliability ranked “good” in the comparison between PeO and NPeO. In fully trained paediatric orthopaedic surgeons, an “excellent” interobserver reliability was found but was only “good” in the NPeO cohort. Conclusions: In conclusion, after careful preparation, at least six months of observation of children with CTEV, PirS and DimS proved to be valid in terms of clinical evaluation. However, more experience with CTEV leads to a better clinical evaluation.

Reproducibility of pop sensation, Thompson sign in achillotomy, and final Pirani score to predict clubfoot relapse: Achillotomy clinical signs and Pirani predictive ability

“…Patients were treated according to the Ponseti method, [23][24][25] which involves manipulating the cavus deformity, followed by maintaining foot abduction beneath the talus head and correcting all deformity elements simultaneously, except for equinus, which was addressed through PAT. Plaster cast was padding and molding, commenced at the heel and extended to the thigh Deformity correction was evaluated using the Pirani scale, which has an interobserver kappa of 0.63 to 0.80 [26,27] and considers visual aspects (medial and posterior crease, curvature of the lateral border), palpation (coverage of the talus and empty heel), and functional aspects (rigidity equinus). Each sign was scored 0 (normal), 0.5 (moderate deformity), or 1 (severe deformity), with a maximum possible score of 6.…”

Bone Development and Disease in Infants

“…The collection starts with the latest research works on a timeless topic: clubfoot. In the first communication, the analysis of the reliability of Pirani and Dimeglio scores in different medical figures (from residents to orthopedic surgeons) provides a picture of two solid evaluation methods that can be used widely by the medical community, especially for congenital talipes equinovarus [1]. Then, another selected manuscript regarding clubfoot analyzes sport ability during walking age following the Ponseti method: once again, it proves to be a valid therapeutic tool for these little patients [2].…”