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Comprehensive review of the functional outcome evaluation of clubfoot treatment: a preferred methodology

Graf, Adama; Wu, Kuan-Wenb; Smith, Peter A.a; Kuo, Ken N.b,c; Krzak, Josepha; Harris, Geralda,d

Journal of Pediatric Orthopaedics B: January 2012 - Volume 21 - Issue 1 - p 20–27
doi: 10.1097/BPB.0b013e32834dd239

Treatment outcome has been a focus of interest in those who manage clubfeet. Because of a lack of a common evaluation protocol, it has become necessary to establish a universally recognized quantitative measurement to compare and better understand the treatment outcome. The outcome is not merely morphological and radiographic, but it should also include functional and quality-of-life measurements. In this article, we will outline the most commonly used methods of long-term evaluation for congenital clubfeet and recommend the data collection parameters that are most appropriate for a comprehensive functional analysis. This will begin with pretreatment classifications that are important in prognosticating the results. The physical examinations and plain radiographs in standing position are also two fundamental evaluations of clubfoot. Several outcome evaluations have been published in the literature and may be useful depending on the desired metrics. Gait analysis is an additional useful technical tool for analyzing the motion of the foot and ankle and its relation to the whole body function; pedobarography added to the dynamics of the evaluation. Functional quality-of-life questionnaires are increasing in popularity for measuring the total body functional status and the quality of life.

aShriners Hospital for Children, Chicago

bNational Taiwan University Hospital

cCollege of Medicine, Taipei Medical University, Taipei, Taiwan

dMarquette University, Milwaukee, Wisconsin, USA

Correspondence to Ken N. Kuo, MD, College of Medicine, Taipei Medical University, 350 Wu-Hsing Street, Taipei 110, Taiwan Tel: +886 2 2736 1661; fax: +886 2 2739 0214; e-mail:

© 2012 Lippincott Williams & Wilkins, Inc.