The Pirani Scoring System is Effective in Assessing Severity and Monitoring Treatment of Clubfeet in Children

Background: Pirani scoring system is one of the classification systems and is simple, easy to use in the management of clubfoot; however, there is paucity of studies using Pirani system to determine the severity and monitor progress in the treatment of clubfoot. We therefore set out with the aim of assessing severity and monitoring the progress of treatment using the Pirani scoring system. The study was conducted at the Department of Orthopaedics and Traumatology of Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife between January 2011 and June 2015.

Methodology: It was a prospective study of 102 clubfeet in 61 patients less than 3 years of age, and born with idiopathic congenital talipes equinovarus. Corrective serial casts were applied after initial manipulations using Ponseti method. Variables of interest such as the biodata, midfoot score, hindfoot score, Pirani score, need for tenotomy and the number of casts to achieve correction were measured. The data obtained were subjected to statistical analysis using SPSS version 22. Significant statistical inferences were drawn at p<0.05.

Results: The correlation between the midfoot score, hindfoot score, Pirani score and the number of casts to achieve correction was significant (p<0.001). Also, there was correlation between the Pirani score and the need for tenotomy (p<0.001),;between the number of casts to achieve correction and the need for tenotomy (p<0.001). Moreover, the progress of treatment can be monitored with the Pirani score (p<0.001).

Conclusion: Pirani scoring system is a simple and reliable system to determine severity and monitor progress in the treatment of clubfoot.