Clinical Evaluation of the Pirani and Dimeglio Scoring Systems and their Correlation with the Number of Casting Sessions Using the Ponseti Method for Idiopathic Clubfoot Treatment

Background: Few studies have investigated which of the classification systems between Dimeglio and Pirani best correlates with the number of casts required to achieve clubfoot correction. This study aims to analyse the two scoring systems to determine the best in predicting number of casting sessions required for idiopathic clubfoot correction. Objectives: To determine the correlation between the Pirani and Dimeglio scoring systems with the number of casts required for correction of idiopathic clubfoot using Ponseti method of treatment. Material and Methods: This work was a 12 months prospective interventional study. 55 Patients with 94 idiopathic clubfeet who met the selection criteria and consent given by their Parent/guardian were recruited for the study. Each clubfoot was scored at presentation using the Pirani and Dimeglio scoring systems. All clubfeet were treated using the Ponseti method until correction was achieved (with or without percutaneous tenotomy). The correlation between the two scoring systems and the number of casts required to achieve correction was analysed. Results: The mean number of casts required to achieve initial correction was 4.38 (range: 2-7). There was a positive correlation between the Pirani scores at presentation (r=0.854, p=<0.001) and the Dimeglio scores at presentation (r=0.809, p=<0.001) with the number of casts required to achieve correction. Multiple linear regression analysis showed that the Pirani score at presentation significantly predicts the total number of casts better than Dimeglio scores. Conclusion: The Pirani score showed better accuracy in predicting the total number of casting sessions required for correction of idiopathic clubfoot.