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Health-related quality of life in twins with clubfoot

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

Abstract
Abstract
Introduction
Clubfoot is one of the most common congenital orthopaedic conditions requiring treatment. The aim of this study was to examine health-related quality of life (HRQoL) in patients with congenital clubfoot (CTEV).
Materials and methods
All 46,418 twins registered in the Danish Twin Registry born from 1931 to 1982 was 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.
Ninety-four reported to have clubfoot giving a self reported prevalence of 0.27% (95% c.i. 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 vs. 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 vs. 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.

Key words: Health-related quality of life HRQoL Twins Clubfoot



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