Ankur Agarwal1, Sumit Gupta2, Sheetal Agarwal3. 1. Department of Orthopaedics, Superspecialty Pediatric Hospital & Postgraduate Teaching Institute, Sector 30, Noida, 201303, India. 2. Department of Orthopaedics, Lady Hardinge Medical College & Associated Kalawati Saran Children's Hospital, New Delhi, 110001, India. 3. Department of Paediatrics, PGIMER & Dr Ram Manohar Lohia Hospital, New Delhi, 110001, India.
Abstract
INTRODUCTION: Various clubfoot severity scoring systems are known to us. Dimeglio and Pirani Scoring systems are most widely used. Also, various treatment outcome measures have been proposed by researchers to assess patient satisfaction and results of treatment. None of the available methods are widely popular and amenable for routine use. A "nwdps protocol" was proposed for functional assessment of patients with clubfoot correction, where "n" was no pain during walking or running; "w" was ability to wear normal shoes; "d" was no significant difference in foot/shoe size of both sides; "p" was plantigrade foot and "s" was ability of the child to squat without heel lift-off. The aim of this study was to test this functional outcome assessment tool for easy day to day use post clubfoot correction. METHODS: The nwdps protocol was applied to all the children at followup on a yearly basis who underwent clubfoot deformity correction in Department of Orthopaedics of our Institute between March 2016 and January 2018. RESULTS: Eighty children were enrolled for the study, 45 had bilateral affection while 35 had unilateral affection. In all 125 feet were treated for clubfoot correction and evaluated using nwdps protocol. Each child was assessed by 2 researchers independently. There was no difference in functional assessment of 2 observers. Fifty-nine children were nwdp positive, one was nwps positive, while 2 were dwps positive at the end of 1 year. 79 children became nwdps positive at the end of 2nd year of followup. CONCLUSION: Nwdps protocol is a very easy to remember and easy to use functional outcome assessment tool post clubfoot correction with high degree of objectivity and interobserver reliability. LEVEL OF EVIDENCE: Level IV.
INTRODUCTION: Various clubfoot severity scoring systems are known to us. Dimeglio and Pirani Scoring systems are most widely used. Also, various treatment outcome measures have been proposed by researchers to assess patient satisfaction and results of treatment. None of the available methods are widely popular and amenable for routine use. A "nwdps protocol" was proposed for functional assessment of patients with clubfoot correction, where "n" was no pain during walking or running; "w" was ability to wear normal shoes; "d" was no significant difference in foot/shoe size of both sides; "p" was plantigrade foot and "s" was ability of the child to squat without heel lift-off. The aim of this study was to test this functional outcome assessment tool for easy day to day use post clubfoot correction. METHODS: The nwdps protocol was applied to all the children at followup on a yearly basis who underwent clubfoot deformity correction in Department of Orthopaedics of our Institute between March 2016 and January 2018. RESULTS: Eighty children were enrolled for the study, 45 had bilateral affection while 35 had unilateral affection. In all 125 feet were treated for clubfoot correction and evaluated using nwdps protocol. Each child was assessed by 2 researchers independently. There was no difference in functional assessment of 2 observers. Fifty-nine children were nwdp positive, one was nwps positive, while 2 were dwps positive at the end of 1 year. 79 children became nwdps positive at the end of 2nd year of followup. CONCLUSION: Nwdps protocol is a very easy to remember and easy to use functional outcome assessment tool post clubfoot correction with high degree of objectivity and interobserver reliability. LEVEL OF EVIDENCE: Level IV.
Authors: Eugene G Jameson; Jon R Davids; Jason P Anderson; Roy B Davis; Dawn W Blackhurst; Lisa M Christopher Journal: J Pediatr Orthop Date: 2008-03 Impact factor: 2.324