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Patient-based outcomes following clubfoot surgery: a 16-year follow-up study
Michael G Vitale1, Julie C Choe, Mark A Vitale
1International Center for Health Outcomes and Innovation Research, College of Physicians and Surgeons and the Joseph L. Mailman School of Public Health, Columbia University and New York Presbyterian Hospital, New York, New York, USA. mgv1@columbia.edu
Abstract:
The ongoing controversy regarding the appropriate treatment of clubfoot has resulted in much variability in practice patterns, making the assessment of long-term outcomes a difficult one. Recently, new patient-based measures of outcomes have allowed for improved methods of assessing health outcomes in children. The purpose of this study was to follow up on a cohort of adolescents who underwent surgical repair at the authors' institution. Traditional (radiographs) and patient-based measures were obtained from 24 patients. The Child Health Questionnaire showed that the quality of life of these patients was relatively high after surgery, and these scores were comparable to those of age-matched young athletes with healthy feet. The disease-specific instrument, which was also administered, showed similar results. The role of radiographic measures was limited, as they did not reflect patient-based outcomes after clubfoot surgery. Both generic and disease-specific measures should be used as primary endpoints in evaluating treatment results in this area.