CAN THE PIRANI SCORE PREDICT THE NECESSITY OF ACHILLES TENOTOMY FOR IDIOPATHIC CLUBFOOT PATIENTS TREATED WITH THE PONSETI METHOD?

Abstract

Background: Idiopathic clubfoot is one of the most common congenital problems affecting newborns. Several methods are used for grading its severity, of which Pirani score is the most reliable one. The Ponseti method of clubfoot management is effective, producing better results and fewer complications than traditional surgical methods. Methods: The study includes 27 clubfeet who were diagnosed with clubfoot and who were scored using Pirani score and were treated with the Ponseti method with possible Achilles tenotomy. Result: The study showed that the mean Pirani scores before treatment were significantly higher in the tenotomy than in the non-tenotomy group (3.54 vs. 2.23 for the total Pirani score, 2.25 vs. 1.69 for the midfoot Pirani score and 1.29 vs. 0.59 for the hindfoot Pirani score). The study proposes a “before treatment” cutoff point of 2.75 for the total Pirani score, 1.75 for the midfoot Pirani score and 1.25 for the hindfoot Pirani score, where a score above these cutoff points can predict the need for tenotomy. Conclusion: This study showed that the Pre-treatment Pirani score can help surgeons decide whether to do tenotomy or not in patients treated with the Ponseti method.