Outcome Measures in Clubfoot

The Ponseti method for the treatment of clubfoot is in widespread use around the globe, and while a variety of measures or tools have been used to evaluate outcomes, few have been validated in different contexts, and none have been standardized or universally accepted. Our goal is to review how outcomes are currently reported in the clubfoot literature, and we have chosen to frame the discussion based on a conceptual model, namely the World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF). We have chosen to group outcome measures based on whether they are "impairment-based" or "function-based", the latter being subcategorized as healthcare provider-reported, patient/proxy-reported, or hybrid. Finally, we discuss the limitations of how clubfoot outcomes are currently reported, the challenges in accepting a universal outcome measure, and encourage the clubfoot researchers and clinicians to develop an outcome measure that can be used across cultures and throughout the developed and developing world, to homogenize clubfoot outcome measures and improve the standard-of-care.