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Volume 9
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10.3390/children9060865
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Article

The Predictive Value of Radiographs and the Pirani Score for Later Additional Surgery in Ponseti-Treated Idiopathic Clubfeet, an Observational Cohort Study

by
Sophie Moerman
1,*,
Nienke Zijlstra-Koenrades
2,
Max Reijman
3,
Dagmar R. J. Kempink
3,
Johannes H. J. M. Bessems
3 and
Suzanne de Vos-Jakobs
3
1
Department of Children’s Orthopaedics, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
2
Rehabilitation Center Vogellanden, 8013 XZ Zwolle, The Netherlands
3
Erasmus MC, Sophia Children’s Hospital, 3015 CN Rotterdam, The Netherlands
*
Author to whom correspondence should be addressed.
Children 2022, 9(6), 865; https://doi.org/10.3390/children9060865
Submission received: 6 May 2022 / Revised: 5 June 2022 / Accepted: 6 June 2022 / Published: 10 June 2022
(This article belongs to the Special Issue Orthopaedics and Biomechanics in Children)
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Abstract

There are few validated predictors of the need for additional surgery in idiopathic clubfeet treated according to the Ponseti method. Our aim was to examine if physical examination (Pirani score) and radiographs at the age of three months (after initial correction of the clubfeet) can predict the future need for additional surgery. In this retrospective cohort study, radiographs of idiopathic clubfeet were made at the age of three months. The Pirani score was determined at the first cast, before tenotomy, and at the age of three months. Follow-up was at least five years. The correlation between the radiograph, Pirani score, and the need for additional surgery was explored with logistic regression analysis. Parent satisfaction was measured with a disease-specific instrument. The study included 72 clubfeet (50 children) treated according to the Ponseti method. Additional surgery was needed on 27 feet (38%). A larger lateral tibiocalcaneal angle (i.e., equinus) and a smaller lateral talocalcaneal angle (i.e., hindfoot varus) at the age of three months were correlated with the need for additional surgery. Higher Pirani scores before tenotomy and at the age of three months also correlated with additional surgery. Parent satisfaction was lower in patients who needed additional surgery. Both the Pirani scores and the lateral radiographs are predictive for future additional surgery.
Keywords: clubfoot; radiograph; Pirani score; additional surgery clubfoot; radiograph; Pirani score; additional surgery

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MDPI and ACS Style

Moerman, S.; Zijlstra-Koenrades, N.; Reijman, M.; Kempink, D.R.J.; Bessems, J.H.J.M.; de Vos-Jakobs, S. The Predictive Value of Radiographs and the Pirani Score for Later Additional Surgery in Ponseti-Treated Idiopathic Clubfeet, an Observational Cohort Study. Children 2022, 9, 865. https://doi.org/10.3390/children9060865

AMA Style

Moerman S, Zijlstra-Koenrades N, Reijman M, Kempink DRJ, Bessems JHJM, de Vos-Jakobs S. The Predictive Value of Radiographs and the Pirani Score for Later Additional Surgery in Ponseti-Treated Idiopathic Clubfeet, an Observational Cohort Study. Children. 2022; 9(6):865. https://doi.org/10.3390/children9060865

Chicago/Turabian Style

Moerman, Sophie, Nienke Zijlstra-Koenrades, Max Reijman, Dagmar R. J. Kempink, Johannes H. J. M. Bessems, and Suzanne de Vos-Jakobs. 2022. "The Predictive Value of Radiographs and the Pirani Score for Later Additional Surgery in Ponseti-Treated Idiopathic Clubfeet, an Observational Cohort Study" Children 9, no. 6: 865. https://doi.org/10.3390/children9060865

APA Style

Moerman, S., Zijlstra-Koenrades, N., Reijman, M., Kempink, D. R. J., Bessems, J. H. J. M., & de Vos-Jakobs, S. (2022). The Predictive Value of Radiographs and the Pirani Score for Later Additional Surgery in Ponseti-Treated Idiopathic Clubfeet, an Observational Cohort Study. Children, 9(6), 865. https://doi.org/10.3390/children9060865

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