Assessment of late results of surgery in talipes equino-varus: a reliability study

Abstract

The variability of a method for clinical and functional assessment of the long-term results of surgical correction of idiopathic congenital talipes equino varus was studied in ten boys and four girls (average age: 19.1 (SD 2.3 years); 22 affected feet) with radiographical evidence of fusion of the foot and ankle ossification centres. Patients were measured twice, 1 week-1 month apart, by the same investigator and were assessed twice on each visit. Assessment included anthropometry, functional assessment and subjective functional evaluation. Calf circumference, skinfold thickness, foot length and width were highly reproducible. Foot length was not significantly influenced by the operation whereas calf circumference, skinfold thickness and foot width were. Although highly reproducible, hopping was not significantly affected by operation. Active and passive range of motion were significantly different. Each was highly reproducible and both were significantly affected by the operation. Patients reported a high and highly reproducible (within two points) functional level.

Conclusion: An assistant-administered functional questionnaire together with measurement of active and passive range of motion allows easy, valid and reproducible assessment of long-term results of surgery for idiopathic congenital talipes equino-varus correction. A significant effect of the number and type of operation was evidenced.