Korelasi dan Hubungan Sistem Skoring Klinis Pirani dengan Studi Parameter Radiologis pada Pasien Congenital Talipes Equinovarus

Abstract

INTRODUCTION Congenital talipes equinovarus (CTEV) is one of the most common musculoskeletal congenital deformity, involving around 1:1000 population in the world. Diagnosing CTEV isn’t difficult, clinical finding of CAVE as the main deformity of is this condition is enough for emphasizing the diagnosis itself.What’s more challenging is the management of CTEV that have a wide range variety of deformity severities. Pirani scoring system is a clinical CTEV severity assessment tools that has been widely used globally, while radiological study role in CTEV cases still questionable and yet to have accepted standard. This study purposed to evaluate the correlation between total Pirani score (TPS) and four radiological parameter that considered represent each of CAVE deformity which is talocalcaneal and talo-1st metatarsal angle from AP view and tibiocalcaneal and talo-1st metatarsal angle from lateral view. MATERIAL & METHOD This study was conducted in a hospital in Medan started from Febuary 2024. The inclusion criteria is all idiopathic CTEV cases with parents or guardians who have agreed to participate after being given an explanation of the purpose and risk of this study. As the exclusion criteria are secondary CTEV due to other associated cause. All sample underwent clinical assessment using Pirani scoring system and followed by xray examination on the same day for radiological parameter measurement purpose. General information (age, gender, bilateral versus unilateral), TPS and all radiological parameter measurement documented for thorough analysis. RESULT Thirty two feet sample was collected from 21 children consisting of 13 boy (61,9%) as majority and 8 girl (38,1%) with age average is 20,1 months old (±18,30) ranging from 2 months old to 5 years old. Eleven children (52,4%) were affected bilaterally, 7 (33,3%) on the right foot and 3 (14,3%) on the left foot. Average TPS from 32 collected feet was 3,20 (±1,54). Talocalcaneal angle (AP) showing significant correlation and strong coefficient (p=0,012) with TPS. Talo-1st metatarsal angle (AP) showing significant correlation with strong coefficient (p=0,023) to TPS. Tibiocalcaneal (lateral) also showing significant correlation but with moderate coefficient (p=0,042) to TPS. Talo-1st metatarsal angle (lateral) showing significant correlation and strong correlation (p=0,021). CONCLUSION Significant correlation with TPS have made radiologic parameter study could be adependable and reliable instrument for assessing severity of CTEV deformity especially in preoperative planning and postoperative follow up in any procedure.