Correlation of scores with number of Ponseti casts required for clubfoot correction in the older child

BackgroundWe examined the correlation between initial Pirani and Dimeglio scores and their individual components to the number of casts for older clubfoot children.MethodsTwenty seven patients (39 feet) aged 2–11 years with idiopathic clubfeet were treated using the Ponseti technique and correlation with number of corrective casts calculated. The number of cast required was counted from application of primary cast to the time of initiation of the foot abduction orthosis.ResultsAverage 8.45 ± 2.31 (range, 4–13) casts were used for treatment. A low correlation (r = 0.203) was identified when total Dimeglio score was compared with the number of casts. No correlation was identified for Pirani score (r = 0.023). Among individual components, only cavus deformity had a significant positive correlation to cast numbers.ConclusionsThe Pirani and Dimeglio classifications still remain the most widely practiced clubfoot severity grading systems for the older clubfoot child. However, their prognostic value to predict the total cast duration from initial severity remains questionable.