The clubfoot classifications described by Pirani and by Dimeglio are in widespread use today in foot and ankle surgical practice and are used to differentiate between lesions and compare treatment results. The aim of the present study was to determine whether in an independent center, one or both classification systems can be implemented practically and in a reproducible manner. From January 2004 to January 2014, we conducted a prospective study concerning the classification systems for clubfoot. The study group included 280 children (411 feet). The mean Dimeglio score noted by the 2 examiners was 10.3 ± 0.69 and 10.6 ± 0.81 points for the 411 feet, respectively. The mean difference in the Dimeglio scoring system was 1.11 ± 0.43 points (95% confidence interval 1.5 points). The Pearson correlation coefficient was 0.85. The corresponding mean Pirani scores were 5.1 ± 0.23 and 5.3 ± 0.17 points for the 411 feet. The mean difference in the Pirani score was 0.65 points (95% confidence interval 0.45 points). The Pearson correlation coefficient was 0.89. The good correlation coefficient for the Dimeglio and Pirani systems recommends their simultaneous use in clubfoot examinations, because the aspects under investigation (reducibility and foot aspect) are both different and complementary.
Level of Clinical Evidence
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to The Journal of Foot and Ankle Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- The need for biomechanical evaluation in the assessment of clubfoot.Foot. 2004; 14: 72-76
- An independent assessment of two clubfoot-classification systems.J Pediatr Orthop. 1998; 18: 323-327
- A Method of Evaluating the Virgin Clubfoot with Substantial Interobserver Reliability. vol 71. POSNA, Miami, FL1995
- Classification of clubfoot.J Pediatr Orthop. 1995; 4: 129-136
- Preoperative clinical assessment of clubfoot.in: Simons G.W. The Clubfoot. Springer-Verlag, New York1993: 97-98
- A method of assessment of the clubfoot deformity.Clin Orthop. 1991; 264: 48-53
- Classification and evaluation of congenital talipes equinovarus.in: Simons G.W. The Clubfoot. Springer-Verlag, New York1993: 120-139
- Validity and responsiveness of the Clubfoot Assessment Protocol (CAP): a methodological study.BMC Musculoskeletal Disorders. 2006; 7: 28
- The Clubfoot Assessment Protocol (CAP): description and reliability of a structured multi-level instrument for follow-up.BMC Musculoskeletal Disorders. 2005; 6: 40
- The classification of congenital talipes equinovarus.J Bone Joint Surg. 2002; 84: 1020-1024
- The classification of clubfoot: a practical approach.Foot. 2003; 13: 61-65
Published online: November 13, 2014
Financial Disclosure: None reported.
Conflict of Interest: None reported.
© 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.