Relationship of the severity of talipes equinovarus and age of presentation to time of correction: A focus on Dimeglio scoring

Abstract

Objectives: The Ponseti method is the mainstay of treatment of congenital talipes equinovarus deformity. This study aims to assess the relationship between the severity of the clubfoot deformity and the time it takes to correct the deformity using Dimeglio scoring system (DSS) with Ponseti protocol. Material and Methods: A prospective observational study carried out for 15 months at the outpatient department of the National Orthopedic Hospital Enugu. Data collected included age at presentation, sex, laterality, grade of deformity, number of casts, and time to correction before the commencement of bracing. Those selected were clinically assessed using the DSS. Data obtained were analyzed using SPSS version 22.0. The association between time, the number of casts to correction, age of presentation, and severity to the time of correction of deformity was also determined. Results: A total of 70 patients (116 feet) were recruited for the study. The mean age at presentation was 21 weeks with a male-to-female ratio of 3:2. The mean DSS at presentation was 10.72. The mean number of casts required to achieve correction was 5, with the last cast left in place for 3 weeks, which gave a mean correction time of 7 weeks. Severe deformity required more cast for correction. There is a weak relationship between age and time to correction. Conclusion: Increase in the severity of the clubfeet was associated with longer correction time and a weak correlation with age at presentation. Dimeglio scoring is an effective, grading, and monitoring system.