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Interobserver reliability of Pirani scoring for idiopathic clubfoot in walking-age children.

J Pediatr Orthop B

January 2025

Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Delhi, India.

Pirani scoring system is one of the most commonly used tools to assess the initial deformity, monitor the treatment progression, and identify relapse in clubfoot. The method has been demonstrated to correlate well with the sequential correction of deformity for children under age 1 year. We conducted a study to examine the interobserver reliability of Pirani scores in children of walking-age.

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Introduction: Clubfoot is at times associated with other lower extremity abnormalities, such as leg length discrepancy (LLD). Initial studies in patients treated with extensive soft tissue release (STR) have estimated that LLD is prevalent in 9% to 11% of children with idiopathic clubfoot. However, Ponseti-style serial casting has since replaced STR as the preferred clubfoot treatment method.

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Comparison between unilateral and bilateral clubfoot treated with Ponseti method at walking age: static and dynamic assessment.

J Pediatr Orthop B

October 2024

Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, A.O.U.P. Policlinico Rodolico - San Marco, University of Catania, Catania.

This study evaluated the static, postural, dynamic, and clinical outcomes among five groups of patients: a bilateral CTEV (congenital talipes equinovarus) group treated with tenotomy (n = 14), bilateral CTEV group treated conservatively (n = 6), unilateral CTEV group treated with tenotomy (n = 7), unilateral CTEV group treated conservatively (n = 3), and control group (n = 20). Data were collected through baropodometric examinations and clinical evaluations using Pirani, clubfoot assessment protocol, foot and ankle disability index (FADI), and American Orthopedic Foot and Ankle Society scores. Bilateral CTEV patients treated with tenotomy showed no statistically significant differences compared to healthy controls.

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Clubfoot (CF) is one of the most common musculoskeletal congenital abnormalities. Despite having optimal methods for its treatment, factors associated with the recurrence of CF treatment continue to be a topic of interest. The aim of this study was to perform a scoping review of the existing literature on factors associated with the recurrence of CF following treatment with the Ponseti method in children under 5 years of age.

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Is percutaneous heel cord tenotomy a necessary component in the Ponseti treatment of idiopathic clubfoot deformity?

J Pediatr Orthop B

January 2025

Department of Orthopaedic Surgery, Scottish Rite for Children, Dallas, Texas, USA.

This study aimed to compare outcomes of idiopathic clubfeet (IC) treated with a percutaneous heel cord tenotomy (PHCT) at the conclusion of Ponseti casting with those that were not. A retrospective review of patients enrolled in a single institution prospective clubfoot registry over 19 years was performed. Patients under the age of 3 months with untreated IC managed via the Ponseti method that had a minimum of 2 years follow-up were included.

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