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Progress in Orthopedic Science ISSN: 2146 - 8370
Progress in Orthopedic Science. 2015; 1(1):(3-92)


Health-related quality of life in twins with clubfoot

Vilhelm Engell, Frank Damborg, Mikkel Andersen, Kirsten Kyvik, Karsten Thomsen, Søren Overgaard

Abstract
Introduction: Clubfoot is one of the most common congenital orthopedic conditions requiring treatment. The aim of this study was to examine the health-related quality of life (HRQoL) in twins with congenital clubfoot (CTEV). Materials and Methods: All 46,418 twins registered in the Danish Twin Registry born from 1931 to 1982 were sent a questionnaire. Included in the questionnaire were standardized questions for The Medical Outcome Study Short Form-12 (SF-12). From these questions, we calculated the SF-12 Physical Component Summary scale (SF-12 PCS) and the SF-12 Mental Component Summary scale (SF-12 MCS). These SF-12 values were compared to a control group and to the healthy twin in the twin pairs where only one twin has CTEV. Results: Of the 46,418 twins who received the questionnaire 34,944 (75%) returned it and 34,485 (99% of the responders) answered the question “Were you born with clubfoot?” The overall sex distribution among the responders was 55% (n = 19,037) females and 45% (n = 15,907) males. 94 reported to have clubfoot giving a self-reported prevalence of 0.27% (95% confidence interval 0.22-0.34%). There were 37 twin pairs where both twins answered all questions. There was no difference in the SF-12 PCS between genders (P = 0.37). There was a significant difference in SF-12 PCS though were the controls have a higher score than the CTEV twins, 53.10 versus 50.18 (P = 0.001). There was no difference in the SF-12 MCS (P = 0.202). However, the male CTEV twins had a higher score in SF-12 MCS than their female counterparts, 51.32 versus 48.47 (P = 0.047). There was no difference in SF-12 PCS or SF-12 MCS within the twin pairs (P = 0.32) and (P = 0.15). Conclusion: HRQoL from SF-12 PCS in self-reported CTEV was significantly worse than in controls in a big cohort of Danish twins. There was no difference in SF-12 MCS between the two groups. This indicates that patients with CTEV evaluate their physical health as worse than the control group. CTEV patients evaluate their mental health like the background population. However, female CTEV patients have a lower SF-12 MCS than their male counterparts. We found no difference in SF-12 PCS or SF-12 MCS between the CTEV patient and the healthy twin in the twin pairs where only one twin has CTEV