Subjective and objective outcome in congenital clubfoot; a comparative study of 204 children

David Chesney, Simon Barker & Nicola Maffulli

Outcome following management of congenital talipes equinovarus (clubfoot) can be assessed in a number of ways. Bjonness suggested that the patient be the final judge and therefore a subjective assessment, whereas others have employed objective measures. Combining both is likely to give a more comprehensive picture of the final result of clubfoot. The purpose of this study was to compare subjective and objective outcome following management of clubfoot, and evaluate sex differences in outcome.

The authors used a patient subjective assessment of outcome following treatment of clubfoot and compared this with objective anthropometry and range of movement of the ankle to assess and compare the subjective and objective outcome. Pearson correlation coefficients were used to analyse the statistics and significance was evaluated by using the Student's T-test.

Objective outcome measures can be the length of the foot, calf circumference and range of movement at the ankle. The authors used these as they were found to be easily reproducible, simple to measure and correlate well with a subjective outcome. Objective outcome is comparable for boys and girls. However, subjectively, female patients and their parents are less happy with the results of management of clubfoot. In conclusion, there was found to be a correlation between the anthropometric measures and the subjective outcome and an objective grading can be designed using foot length, calf muscle bulk and range of movement at the ankle.

BMC Musculoskeletal Disorders 2007, 8:53

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