Radiological study of anatomical bony arrangement of the clubfoot deformity and its correlation with the Pirani clinical scoring system: A multicenter study.

ABSTRACT

Club foot or congenital talipes equinovarus (CTEV) is a common developmental disorder of the foot, affecting 1 per 1,000 live births. The main goal of this study is to evaluate the anatomical bony arrangement of the clubfoot deformity radiologically and to correlate this arrangement with the Pirani clinical scoring system. This descriptive, analytical study was conducted in three centres in Sudan. It recruited all the patients of both sexes with CTEV attending these centres, and excluding children on conservative cast and those who already had surgery. Data were collected using structured questionnaire. Pirani clinical scoring system, a reliable clinical assessment method, was applied. Four angles were used to measure each component of the deformity and correlate this with the Pirani score. Feet radiology was performed to assess the bone anatomy. The index cases number was 25 with male-to-female ratio of 1.61. Both feet were involved simultaneously in about half of the cases. Only the dorsoplanter (DP) and lateral (L) views talo-1st metatarsal angle was used to describe the forefoot adduction and mid-foot cavus, respectively. These correlated significantly with the clinical score of Pinari, whereas the other two measures for the equinus and varus did not. The results matched with the demographic description of the deformity found in the literature. Further studies are warranted that combine both the clinical assessment and the X-ray measurements in one score to classify the severity of the deformity and guide the management options.