A new scoring system for the evaluation of clubfoot: The IMAR-Clubfoot scale

Abstract 

Background

Recently much interest has been shown regarding the biomechanical techniques for the assessment of clubfoot but as yet their specific role in such an endeavour is unclear. Several scoring systems have been designed but none have been adopted as a standard. The ideal system should be simple, modular, reliable, repeatable and be able to assess functional deformity objectively.

Objective

This study was aimed to develop a comprehensive scoring system and to demonstrate the potential of such an assessment tool in evaluating clubfoot.

Methods

A new innovative scoring system, the IMAR-Clubfoot scale, was designed, which incorporated clinical and biomechanical data. Clinical assessment was performed using a questionnaire and standard clinical criteria while the biomechanical evaluation was undertaken using the Podotrack^®, the optical dynamic pedobarograph and the GAITRite^® systems. Thirteen children (16 clubfeet) were recruited for assessment using the IMAR-Clubfoot scale.

Results

The model can detect abnormalities related to talipes equinovarus and quantify them objectively. The results also emphasise the need for such a comprehensive system, which combines clinical and biomechanical data as there was no statistical correlation between these data.

Conclusion

The scoring system would be helpful in assessing the deformity, deciding upon appropriate management and objectively defining the success/failure of treatment at patient follow-up.

Keywords: Clubfoot, Clinical assessment, Biomechanical assessment, Foot pressure analysis, Scoring system