Interobserver reliability of foot bimalleolar angle in different pirani scores for the treatment of congenital talipes equino varus


CTEV ; foot bimalleolar (FBM) angle ; interobserver reliability ; Pirani score

Published online: May 29 2020

Neerav Anand Singh, M.P. Singh, A.K. Jain, Rahul Anshuman, Vineet Bajaj, Nikhil Verma

From the Department of Orthopaedics, UCMS and ass. GTBH, Delhi, India


Congenital talipes equino varus is one of the most common musculoskeletal deformity and to classify the severity of deformity Pirani score, Dimegleo classification, Harrold and Walker system are available, but they lacks objectivity. Foot bimalleolar (FBM) angle, is a simple objective method of assessment of deformity. The interobserver reliability of FBM angle is not studied yet.

A prospective study was done including 150 clubfoot classified in 3 groups according to Pirani score: Group I (0-2.0), Group II (2.5-4.0) and, Group III (4.5-6.0). Pirani scoring was done by one observer & FBM angle calculated by 3 other observers.

Intraclass correlation coefficients (ICC) and their 95% CI were used. ICC was 0.75, 0.74 (p<0.05) & 0.54 (p>0.05) i.e. excellent, good and fair in Group I to III respectively.

Interobserver reliability improves from fair, good and excellent with treatment. Hence FBM angle is a good objective method of assessment of deformity.