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Journal of Bone and Joint Surgery - British Volume, Vol 84-B, Issue 7, 1020-1024.
doi: 10.1302/0301-620X.84B7.12909  
Copyright © 2002 by British Editorial Society of Bone and Joint Surgery
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The classification of congenital talipes equinovarus

A. M. Wainwright, FRCS (Trauma & Orth), Specialist Registrar; T. Auld, MCSP, Senior Physiotherapist; M. K. Benson, FRCS, Consultant Orthopaedic Surgeon; and T. N. Theologis, FRCS, Consultant Orthopaedic Surgeon

Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford OX3 7LD, UK.

Correspondence should be sent to Mr T. N. Theologis.

We have assessed the reliability of four classification systems for club foot. Four observers evaluated nine children (18 feet) at different stages in the first six months of life, a total of 180 examinations. Each observer independently assessed all feet according to the classification systems described by Catterall, Diméglio et al, Harrold and Walker, and Ponseti and Smoley.

The variation between observers was assessed using the kappa test which for no more agreement than chance has a value of 0, and for complete agreement between observers a value of 1. The kappa values varied between 0.14 and 0.77 depending on which classification system was used. The system of Diméglio et al was found to have the greatest reliability.

Our findings suggest that current classification systems for the analysis of congenital talipes equinovarus are not entirely satisfactory.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General