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Assessing Results of Treatment for Clubfoot

Posted on: 09/28/2006
Researchers from India report on three aspects of clubfoot deformity in children. Their main goal is to find a standard way to measure results after treatment. Testing must be valid, accurate, and reliable. Others using the same test should be able to reproduce the same results.

The authors started by using four scoring systems already available. Fifty children with clubfoot deformity were assessed using these scoring systems. Pain, function, motion, and gait were measured. X-ray results and deformity were also included.

They found the tests from system to system didn't give the same results. The authors devised their own testing instrument. From their own system of tests and measurements, they report that morphology, function, and tarsal (bones of the foot) do influence each other and the results. Morphology refers to the structure and appearance of the foot.

This study also showed that using X-ray findings alone is not the best way to measure the outcomes. Some X-ray views do not correlate with the structural or functional results and can be omitted. The authors suggest that X-rays don't take into account muscle power and its ability to improve deformity and function.

They conclude that a common language for evaluating clubfoot is needed. Using morphology, function, and appropriate X-ray studies may be a better solution. A scoring system must be reproducible before it can be adopted as a standard tool to assess results of treatment.

References:
Sandeep Munshi, MS Orth, et al. Evaluation of Outcome of Treatment of Congenital Clubfoot. In Journal of Orthopaedic Pediatrics. September/October 2006. Vol. 26. No. 5. Pp. 664-672.

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