Clubfoot history¶
In this screen you will need to add the clubfoot history of the patient, for both feet. By default, the feet are scored as “not a clubfoot” and “no previous treatment”.
What do you do?¶
- In general
You need to fill in the clubfoot history for both feet. The first screen that appears is the screen for the right foot. After filling in everything you need to click on “Continue to Left Foot”.
Now the screen for the left foot appears. Again, you need to fill in everything, and once you are satisfied with the answers, you can click on “Save”.
More information about the fields
The item ‘previous clubfoot diagnosis’. Make sure you fill in the correct diagnosis.
Idiopathic not walking = child with idiopathic clubfoot diagnosed before child started to walk.
Idiopathic walking = child with idiopathic clubfoot diagnosed after child started to walk.
Syndromic = clubfoot seen in a child with an identified syndrome or other congenital abnormalities.
Post surgical = clubfoot that has been treated with joint invasive surgery such as Posterior/Posteromedial release.
Complex = clubfoot with a complete transverse plantar crease that appeared after casting treatment started. Usually there is a history of a cast slip.
Atypical = clubfoot with a complete transverse plantar crease that was present before any treatment started.
Not treatable by Ponseti method
Not a clubfoot
The item ‘recurrence count’: Fill in how many times the patient had a recurrence, including this visit. This might be different for different situations, so therefore we provide two examples below:
When you see a patient that has already been to your clinic, and for which you have already filled in previous visits in PCN, PCN will automatically compute the recurrence count and you do not have to change the recurrence count.
When you see a patient for the first time (e.g. when the patient went to another clinic for their previous visits and is referred to you) there is no information in PCN about the previous visits and PCN cannot automatically compute the recurrence count. This means that you have to fill in the recurrence count manually. If you have reason to suspect that there has been a relapse before (when the patient went to the other clinic), please include this in the recurrence count. If you have no evidence of a recurrence in the previous visits of the patients, then leave the recurrence count zero.
The item ‘Lateral Cuneiform Ossified Nucleus’: By default, this item is marked as ‘unknown’. Change the status of this item into ‘yes/no’ if there are already x-rays available from the child.
- Sidenotes:
You must fill in the original diagnosis, because you are in the clubfoot history screen, even if this is not the same as the status right now (this is especially important when filling in data retrospectively). This also holds true for the recurrent count (you need to fill in the recurrence count at the time of the patients first visit). It is important for the algorithm and future decisions for treatment that the right information is filled in*