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Clinico-radiological assessment and their correlation in clubfeet treated with postero-medial soft-tissue release

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Abstract

The controversy regarding the radiographic parameter which best represents the various deformities of clubfoot continues. The aim of our study was to clear up this controversy. Fifty surgically treated (soft-tissue release) congenital clubfeet were studied clinically using Laaveg and Ponseti score and radiologically using twelve different radiographic parameters in weight-bearing AP and lateral views. The talo-calcaneal angle (TCA) in AP and lateral view showed statistically significant correlation with the functional rating, but significant variation in the dimension of the angles among the different functional groups was found with AP angle only. The talo-first metatarsal angle in AP and lateral view averaged 10° and 19° respectively, and showed significant correlation with the functional rating. The talo-navicular subluxation in AP, the calcaneo–fifth metatarsal angle and the first–fifth metatarsal angle in lateral view did not show any significant correlation with function. Talo-calcaneal index averaged 44° in the clubfeet and showed significant correlation. The wide range of parameters representing each of the deformities gives a better radiological assessment of the clubfoot than any single parameter.

Résumé

Les paramètres radiographiques des pieds bots sont toujours très discutés. Le but de cette étude est de clarifier les controverses à ce propos. Matériel et méthode : 50 pieds bots opérés (libération interne) ont été étudiés sur le plan clinique en utilisant le score de Laaveg et Ponseti et sur le plan radiographique avec douze paramètres différents, les radiographies étant effectuées en charge de face et de profil. Résultat : l’angle Talo-calcanéen (TCA) de face et de profil est de façon significative associée aux résultats fonctionnels, l’angle talo-métatarsien (du premier métatarsien varie de 10 à 19°) et est également corrélé, de façon significative avec le score fonctionnel. La subluxation talo-naviculaire de face, l’angle calcaneo-métatarsien avec le 5ème méta et le premier méta ainsi que l’angle 1er et 5ème méta de profil ne sont pas corrélés avec le score fonctionnel. L’index talo-calcanéen est en moyenne de 44° et a une importante signification. En conclusion : l’association de ces différents paramètres permet d’avoir une meilleure appréciation radiologique du pied bot bien plus que l’utilisation d’un paramètre isolé.

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Authors and Affiliations

  1. Department of Orthopaedics, PGIMER, O- Block, # 296, MDH, PGIMER, Sector-12, Chandigarh, 160012, India

    Prabhudev Prasad, Ramesh K. Sen, Shivender S. Gill, Emal Wardak & Raghav Saini

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  1. Prabhudev Prasad
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  2. Ramesh K. Sen
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  3. Shivender S. Gill
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  4. Emal Wardak
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  5. Raghav Saini
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Correspondence to Prabhudev Prasad.

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Prasad, P., Sen, R.K., Gill, S.S. et al. Clinico-radiological assessment and their correlation in clubfeet treated with postero-medial soft-tissue release. International Orthopaedics (SICO 33, 225–229 (2009). https://doi.org/10.1007/s00264-007-0448-0

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