Evaluation of a New Score (Performed at the Age of 2 Years) Regarding Clubfoot Recurrence, as Evaluated beyond the Age of >3 Years
2the School of Medicine, The Faculty of Medicine, the Hebrew University of Jerusalem, Israel
Background:
Recurrence is a substantial difficulty of clubfoot management. Although the Ponseti method is relatively successful, it would be important to predict whom will need further treatment after finalizing the standard care (serial casting, tenotomy and bracing). Outcome evaluation tools like the "PBS score" numerically evaluate the outcome of each affected foot, and guide the need for further treatment. An earlier score used at the age of 2 years (Angel score) was previously studied (unpublished results), and a correlation was demonstrated between a score>8 points and the need for further treatment after the standard care is finished. The current study evaluates the correlation of the early Angel-score with a late functional tool (the PBS-score). A high correlation would further substantiate the predictability of the Angel-score
Methods:
Children aged >3 years were evaluated by the PBS-score. Their charts were also retrospectively analyzed for their status at the age of 2 years and the Angel score was calculated . Correlations were sought between background factors including the Angel-score, and PBS results.
Results:
43 children were included (33 males). The age at their index PBS evaluation was 4.35 (range 3.3-7.3) years. Good correlation was demonstrated (by the Pearson correlation coefficient, R=0.6376, p=0.00000426) between the results predicted by the early “Angel-score” and the late functional assessment by the “PBS-score”.
Discussion and Conclusions:
The Angel score is a tool used early (age 2y), for prediction of unfavorable outcome at later stage. The current study supports its usability as a predictor of outcome. The PBS score is a useful and simple older age score. It may guide us regarding the need for further treatment, and allow assessment of outcomes in different centers. The correlation between both implies that unfavorable results are usually evident early.