Developmental Outcomes in Children With Clubfoot: A Twin Study Comparing Affected and Unaffected Siblings

Clubfoot is a congenital condition affecting 1 to 2 per 1000 live births, with treatment primarily involving the Ponseti method and/or surgical intervention. It is important to ascertain whether children affected by clubfoot are prone to developmental delay, as they may benefit from early intervention. While previous research has explored motor and cognitive outcomes in children with clubfoot, these studies often lacked demographically matched controls.

Thirteen twin pairs, including 2 monozygotic and 11 dizygotic sets (26 children), aged 6 months to 7 years, were evaluated using the Mullen Scales of Early Learning (MSEL). This tool assesses 5 developmental domains: gross motor skills, fine motor skills, visual perception, receptive language, and expressive language. Developmental Quotients (DQ) were calculated, and results were analyzed using paired comparisons and normative benchmarks for each group.

Clubfoot-affected children demonstrated no significant differences in cognitive or motor developmental metrics compared with their unaffected siblings. Paired comparisons showed no statistical significance across developmental domains. Some minor differences, which were not statistically significant, were observed in specific domains, such as higher visual reception scores in affected children and slightly better receptive language scores in the unaffected group. No consistent trends favored either group.

Although this study is based on a limited sample size, this first of its kind study suggests that clubfoot, when treated effectively, does not significantly impact cognitive or motor developmental milestones compared with unaffected twins.

Level III-investigating the effect of a patient characteristic on the outcome of disease.