We have assessed the reliability of four classification systems for club foot. Four observers
evaluated nine children (18 feet) at different stages in the first six months of life, a total of 180
examinations. Each observer independently assessed all feet according to the classification
systems described by Catterall, Diméglio et al, Harrold and Walker, and Ponseti and
Smoley. The variation between observers was assessed using the kappa test which for no
more agreement than chance has a value of 0, and for complete agreement between …

We read with interest the article by Reed et al1 entitled 'Extramedullary or intramedullary
tibial alignment guides: a randomised prospective trial of radiological alignment'in the
August 2002 issue. Their article shows the importance of proper alignment of components in
total knee replacement surgery. We feel, however, that their results do not necessarily lead
to the final inference regarding the superiority of intramedullary alignment guides. The
authors mention that they were unable to obtain acceptable radiographs in 35 patients of …