The reliability of pirani scoring system in the management of idiopathic clubfoot using ponseti method

Harish Kumar, R, Senthilnathan, A, Prabhakar, R, Harri Vishnu and Manooj Kumar, V

Introduction: Ponseti method in the treatment of congenital clubfoot has led to a renewed interest in this method among orthopaedicians. Pirani scoring system has been authenticated to analyse the severity and to monitor treatment of clubfoot
Aims & Objectives: The Aim and objectives of the study were to assess the results of Pirani scoring system in terms of the number of foot corrected and the need for tenotomy. This study primarily focuses on our experience in applying the ponseti method in the management of congenital clubfoot.
Methodology: This study was conducted between October 2014 to September 2016. A total of 25 cases & 42 feet were treated by this method with the mean follow-up time of 18 months (6 to 36). The standard method as described by Ponseti using Plater of paris were applied from 3rd week after birth and changed at weekly interval until correction was attained. Percutaneous tenotomy of tendo-achilliswere performed only to persistent equinus deformities. Pirani score was used for assessment of the deformity.
Result: Mean Pirani score improved from the first cast to the time before tenotomy. Tenotomy was required in 32 of the total 42 feet. 6 out of 42 feet were successfully treated by casting only. Of the total 38 feet corrected by serial casting and tenotomy there was no recurrence. The remaining 4 required extensive soft-tissue release.
Conclusion: Pirani scoring system is highly validated in terms of assessment of severity and for monitoring prognosis of idiopathic clubfoot corrected by Ponseti method.

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