CLASSIFICATION OF CLUBFOOT

Clubfeet must be classified according to severity to obtain reference points, assess the efficacy of orthopaedic treatment, and analyze the operative results objectively. A scale of 0-20 was established on the basis of four essential parameters: equinus in the sagittal plane, var us deviation in the frontal plane and derotation around the talus of t he calcaneo-forefoot (CFF) block and adduction of forefoot on hindfoot in the horizontal plane. Four grades of clubfeet can be individualize d: (a) Benign feet so-called ''soft-soft feet,'' grade 1, similar to p ostural feet, with a score of 5 to I (these mild feet must be excluded from any statistics as they tend to increase good results); (b) moder ate feet, so-called ''soft > stiff feet,'' grade II (reducible but par tly resistant, with a score of 5-10); (c) severe feet, so-called ''sti ff > soft feet,'' grade III (resistant but partly reducible, with a sc ore of 10-15); and (d) very severe, pseudoarthrogryposic feet, so-call ed ''stiff-stiff feet,'' grade IV (score of 15-20 points). To avoid ri sks of errors, our method is based on a very complete checklist and on diagrams. Our training material includes an audiovisual package.