A Clinical Evaluation of the Pirani and Dimeglio Idiopathic Clubfoot Classifications

The clubfoot classifications described by Pirani and by Dimeglio are in widespread use today in foot and ankle surgical practice and are used to differentiate between lesions and compare treatment results. The aim of the present study was to determine whether in an independent center, one or both classification systems can be implemented practically and in a reproducible manner. From January 2004 to January 2014, we conducted a prospective study concerning the classification systems for clubfoot. The study group included 280 children (411 feet). The mean Dimeglio score noted by the 2 examiners was 10.3 ± 0.69 and 10.6 ± 0.81 points for the 411 feet, respectively. The mean difference in the Dimeglio scoring system was 1.11 ± 0.43 points (95% confidence interval 1.5 points). The Pearson correlation coefficient was 0.85. The corresponding mean Pirani scores were 5.1 ± 0.23 and 5.3 ± 0.17 points for the 411 feet. The mean difference in the Pirani score was 0.65 points (95% confidence interval 0.45 points). The Pearson correlation coefficient was 0.89. The good correlation coefficient for the Dimeglio and Pirani systems recommends their simultaneous use in clubfoot examinations, because the aspects under investigation (reducibility and foot aspect) are both different and complementary.