Abstract
Although Dimeglio and Pirani scores are frequently employed to rate the severities
of clubfoot and to evaluate treatment outcomes, it is unclear if these scores predict
relapse after treatment. Ankle dorsiflexion has been suggested in recent years to
be a promising predictor of relapse. The aim of this study was to investigate ankle
dorsiflexion and Dimeglio and Pirani scores in predicting the relapse of clubfoot
after treatment with the Ponseti method. We included patients with clubfoot previously
treated by the Ponseti method, and retrospectively analyzed their initial ankle dorsiflexion,
Pirani and Dimeglio scores, number of castings, and the occurrence of relapse. We
analyzed 218 feet of 176 infants with clubfoot who showed an incidence of relapse
of 17.0% (30/176). The mean initial Pirani and Dimeglio scores of the feet showing
recurrence were significantly higher than individuals with non-recurrence (p < .001 each). We observed a robust association between Pirani and Dimeglio scores
and the recurrence of clubfoot at the last follow-up (γ = 0.53, p = .001). In contrast, ankle dorsiflexion was negatively correlated with recurrence
of clubfoot (γ = -0.21, p = .001). Dimeglio scores significantly predicted the recurrence of clubfoot (p = .014). Receiver operating characteristic curve analysis exhibited slightly better
performance regarding the Dimeglio score relative to the Pirani score and ankle dorsiflexion
in predicting recurrence. Ankle dorsiflexion and Pirani and Dimeglio scores were related
to recurrence in patients with clubfoot. However, the Dimeglio score reflected superior
accuracy in predicting the prognosis of clubfoot treated with the Ponseti method.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: June 30, 2022
Footnotes
Financial Disclosure: The authors declare that they have no financial interests/personal relationships which may be considered as potential competing interests.
Conflict of Interest: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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