Treatment of clubfoot with the modified Copenhagen method: A 10-year follow-up

Background: Clubfoot is one of the most frequent congenital malformations in the world. Non-operative methods follows limiting surgery to a minimum. The modified Copenhagen method has not been studied enough. Study Design: longitudinal retrospective study. Objectives: To evaluate prognostic factors for clinical rehabilitation with the modified Copenhagen method in a 10-year follow-up period. Methods: A retrospective study was carried out on a 10-year follow-up of 82 children diagnosed with clubfoot at birth and treated with the modified Copenhagen method. Their sex, side, severity, bilaterality, forefoot orientation, and age when the nonoperative treatment was started were registered, and a cluster analysis was performed to determine which variables were most significant for predicting whether surgical treatment was needed. Results: Of the clubfeet, 13.4% were grade I, 65.9% were grade II, and 20.7% were grade III according to the Harrold and Walker classification. In total, 58 patients needed surgery at some point during the follow-up period. The severity and talo-first metatarsal angle made it possible to determine whether the patients required surgery in 68% (56/82) of the cases. Conclusion: The results of the study suggest the possibility of providing physicians with an algorithm which might facilitate assessing whether the children will require surgery or not, depending on the data obtained from the cluster analysis. Clinical relevance This study provides health professionals with an algorithm that might facilitate assessing whether the children will require surgery or not.