Patient-based outcomes after clubfoot surgery.
Despite decades of experience in the area of clubfoot repair, considerable uncertainty remains regarding indications, surgical technique, and long-term results of treatment. Much of this uncertainty is due to the lack of a standardized and valid method for assessing postoperative outcomes of clubfoot repair. The current study used various end points to compare traditional and patient-based outcome measures and to develop a disease-specific instrument that is both meaningful to the patient and statistically valid. A cohort of 46 patients was identified, and several types of outcomes data were collected, including traditional end points of outcome (range of motion and radiographic criteria, qualitative patient-based data) and a previously validated instrument measuring pediatric functional status (FSIIr). At an average follow-up of 45 months, radiographic measures and range of motion were comparable to values published in previous studies. Postoperative functional status, as measured by the FSIIr, did not differ from that of age-matched controls. Psychometric analysis of these data allowed us to generate a 10-item disease-specific instrument (DSI), which conveyed patient-based attitudes toward outcome.
Roye
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BD
New York Orthopaedic Hospital, Columbia University and the New York Presbyterian Medical Center, USA.
Vitale
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MG
Gelijns
A C
AC
Roye
D P
DP
D002675:Child, Preschool; D003025:Clubfoot / Q000000981:diagnostic imaging / Q000523:psychology / Q000601:surgery*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D008297:Male; D011594:Psychometrics; D011788:Quality of Life; D011859:Radiography; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D016896:Treatment Outcome