A comparison between orthopedic surgeon and allied health worker in pirani score.

OBJECTIVE To assess the strength of agreement for each of the Pirani assessment categories between an orthopaedic surgeon and allied health worker on scoring clubfeet. METHODS The descriptive cross-sectional study was conducted at the Indus Hospital, Karachi, from November 2012 to June 2013, comprised children below 12 months of age with untreated unilateral or bilateral clubfoot deformity an allied health worker, who was a plaster technician, was given 1-week training in the Pirani Scoring method. The feet were scored by the surgeon and the paramedic independently. SPSS 21 was used for statistical analysis. RESULTS The study had 57 patients, and 92 feet were assessed. The difference between the means of score of each parameter, including the hind foot score and total score, was less than 0.09. The means of total score were found to be identical. Total Hind Foot Score was 0.48 and Total Score was 0.354. The statistical inter-observer reliability for all components was rated as substantial to moderate agreement except Equinus Rigidityand Total Score, which showed fair agreement. CONCLUSIONS Pirani scoring method for clubfoot assessment was found to be a reliable tool for use by plaster technicians for independent assessment of clubfoot. However, prior training and supervision in the early phase is necessary.