Clubfoot is a congenital orthopedic deformity of the lower limb in newborns. It is
characterized by a triple deformity of the foot: equinus, supination and adduction of the
forefoot. It can be bilateral or unilateral. PBVE can be idiopathic or associated with
another etiology such as neurological, rheumatological, etc.
There is a muscular hypoplasia of the muscles antagonistic to the PBVE and an imbalance of
force between the agonists and antagonists to the benefit of the deformity. There is also an
abnormality of the fibular and posterior tibial nerves.
The aim of the study is the muscular evaluation of the PBVE. The scientific literature is
relatively poor on the subject. In the first year of life, if the articular evaluation of the
PBVE is very precise, the muscular scoring seems less well taken into account. In the
Dimeglio score, the muscular criterion counts for 1 point (against 16 articular points) if it
is possible to obtain a muscular contraction of the antagonists. It does not specify which
muscles are present nor the active reducibility of the deformity. A scale based on the
Dimeglio score has been created to evaluate muscle activity. To fill it out, the practitioner
will have to stimulate the muscles antagonistic to the deformity by tactile stimulation.
This will be an 8-year prospective cohort study that will look for a correlation between the
muscle deficit and the risk of tenotomy before 1 year as well as the quality of
inter-examiner reproduction of the scale. This duration is necessary to obtain a sufficient
number of inclusions (100 feet).
Infants with idiopathic Clubfoot treated with the functional method at up to 15 days of life
will be included. At the first consultation, we will perform the Dimeglio score and our
muscle activity scale. The Dimeglio and the muscle activity scale will be performed at 3, 6
and 12 months. The population included will need to be sufficient to ensure that all levels
of muscle scoring are represented.
The primary endpoint will be the need for Achilles tenotomy before 1 year. The secondary
endpoint will be inter-examiner reproducibility determined by statistical analysis.
The expectation of this study would be to define a predictive factor of the evolution of the
PBVE in order to refine the treatment earlier.