An interventional study of scale Idiopathic Clubfoot in Clubfoot, sponsored by Fondation Lenval. Recruiting at 1 site in France. Open to participants aged 0 Months to 12 Months. Per ClinicalTrials.gov, last updated 2023-09-29.
Sponsored by Fondation Lenval · Not applicable, Interventional, and Other
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Clubfoot is an orthopedic congenital malformation of the lower limb of the newborn evaluated by the Dimeglio score. There is a deficit of muscular balance between the agonists and antagonists to the deformity. The Dimeglio score takes into account the muscular activity but only up to one point out of 20. This study proposes to use a muscle scale inspired by the Dimeglio score to see if there is a correlation between muscle activity and the risk of tenotomy before 1 year. It will also assess the inter-examiner reproducibility of this scale.
This study is a prospective cohort study with a duration of 8 years to include about 100 feet. Infants with idiopathic Clubfoot treated with the functional method at up to 15 days of life will be included. Feet will be assessed at an inclusion visit and then at 3-6-12 months.
The primary endpoint will be the need for Achilles tenotomy before 1 year of age. 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.
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.
69 studies on the registry are indexed under Clubfoot; 15 are open to participants now.
This study's planned enrollment of 50 is above the median of 38 across 40 interventional studies indexed under Clubfoot.
Browse Clubfoot studies →Fondation Lenval is the lead sponsor of 61 studies on the registry; 18 are open to participants now.
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Exclusion Criteria:
Other: scale Idiopathic Clubfoot
The Dimeglo and the muscle activity scale will be performed at 3, 6 and 12 months with patient with idiopathic clubfoot
Surgery
number of patient who need for Achilles tenotomy
Time frame: maximum 1 year after inclusion
Inter-examiner reproducibility
measure with statistical study the Inter-examiner reproducibility
Time frame: through study completion, an average of 8 years
Started Apr 2023 (actual). Primary completion is estimated for Mar 2031, 95 months after the start.
Of 20 interventional studies with no phase under Clubfoot, half reached primary completion within 11 months of starting (the median), counting those still running; a quarter within 9 and three quarters within 37. This study's planned 95 months is above that.
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