Radiological study of anatomical bony arrangement of the clubfoot deformity and its correlation with the Pirani clinical scoring system: A multicenter study

Hadi, Mustafa Hayder El; Nurein, Mohamed Abdelsalam; Bader, Mustafa Abbas El Sheikh; Salih, Mohamed Mahdy Ali; Babikir, Haydar E.

doi:10.24911/sjp.106-1573461977

Cited by 5 publications

(3 citation statements)

References 18 publications

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“…However, since it is a simple and well tolerated procedure, it would not preclude other types of treatment once rebound occurs. Meanwhile, although previous studies have shown that the talo‐first metatarsal angle used to describe the forefoot adduction correlated significantly with the clinical score of Pirani clinical scoring system 26 , there was no preoperative or postoperative evaluation of foot function. In subsequent studies, it is necessary to increase the sample size, extend the follow‐up time and develop a more perfect evaluation system.…”

Section: Discussionmentioning

confidence: 97%

Outcomes of Eight‐Plate Epiphysiodesis for Residual Clubfoot Deformities

Zhao

Ruan

Cao

et al. 2022

Orthopaedic Surgery

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Objective: The outcome of congenital clubfoot treatment is still challenging if the feet deformities are not completely corrected. Here we explore a minimal invasive procedure with an eight-plate implant to correct the residual forefoot adduction deformity after treatment of neglected or relapsed clubfoot. Methods:We retrospectively reviewed patients with residual forefoot adduction deformity after clubfoot treatment between January 2013 and June 2016. The patients underwent temporary epiphysiodesis of the lateral column of the mid-foot, which in detail, an eight-plate was placed on each side of the calcaneocuboid joint. The foot deformities were recorded according to the weight-bearing radiographic measurements including talo-first metatarsal angle, calcaneofifth metatarsal angle and medial-to-lateral column length.Results: A total of 13 patients (20 feet) with an average age of 7.8 years old were located with an average duration of 40.8 months follow-up (range, 28 to 54 months). The average talo-first metatarsal angle improved from 28.3 (range, 19 to 47 ) preoperatively to 8.3 (range, 3 to 18 ) and the calcaneo-fifth metatarsal angle improved from 29.1 (range, 19 to 40 ) preoperatively to 8.4 (range, 0 to 21 ) at final follow-up. The mean ratio of the medial-tolateral column length improved from 1.14 AE 0.06 to 1.55 AE 0.09 with statistical significance (t = 3.566; P < 0.001).Conclusions: Eight-plate epiphysiodesis is an easy and effective method for the correction of residual forefoot adduction deformity after clubfoot treatment in growing children without the need of osteotomy.

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Section: Discussionmentioning

confidence: 97%

Outcomes of Eight‐Plate Epiphysiodesis for Residual Clubfoot Deformities

Zhao

Ruan

Cao

et al. 2022

Orthopaedic Surgery

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“…In our study, we investigated the predictive value of five angles: TC-AP, TM-AP, TC-L, TIC-L, and TM-L. 13 , 28 In particular, as shown by previous studies, the TM-AP angle can assess the severity of forefoot adduction; the TC-AP and TC-L angles can evaluate the position of the subtalar joint; the TM-L angle can estimate the severity of the midfoot cavus; and the TIC-L angle can evaluate ankle dorsiflexion. 13 , 28 , 29 As a result, these five angular measurements summarize all the IC deformity components. 3 , 7 According to our data, although TC-AP, TM-AP, TC-L, and TIC-L were significantly different between the non-relapsed and relapsed groups, TC-AP (p = 0.57) and TC-L (p = 0.19) had to be excluded because their p-value was >0.05, while only TM-AP (p = 0.033) and TIC-L (p = 0.015) could be included in the predictive formula using the stepwise selection method.…”

Section: Discussionmentioning

confidence: 99%

Are early antero-posterior and lateral radiographs predictive of clubfoot relapse requiring surgical intervention in children treated by Ponseti method?

et al. 2022

Journal of Children's Orthopaedics

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Purpose: To investigate the value of antero-posterior and lateral radiographs in predicting clubfoot relapse after treatment with the Ponseti method. Methods: This was a retrospective review of 104 children (157 feet) younger than 3 months of age with idiopathic clubfoot treated using the Ponseti method at our institution between January 2007 and December 2014. All patients underwent Achilles tenotomy and were divided into two groups according to the need for further surgery to correct the deformity: relapsed group (24 patients; 36 feet) and non-relapsed group (80 patients; 121 feet). All antero-posterior and lateral foot radiographs were performed less than 3 months after Achilles tenotomy. The talo-calcaneal (TC-AP) and talus-first metatarsal (TM-AP) angles were measured in the antero-posterior view, while the tibio-calcaneal (TIC-L), talus-first metatarsal (TM-L), and talo-calcaneal (TC-L) angles were measured in the lateral view. The multi-factor logistic regression model of the stepwise selection method was used to predict the relapse of clubfoot deformity from the potential predictive values. Results: The mean age at initial plain radiography examination was 99.45 ± 21.54 days. Differences in TC-AP, TM-AP, TC-L, and TIC-L between the two groups were statistically significant. However, only TM-AP and TIC-L were included in the “ risk of relapse” formula using the multi-factor logistic stepwise selection method. Conclusion: Early antero-posterior and lateral radiographs in children younger than 3 months of age at initial Ponseti treatment have positive predictive value for relapse. Reduced TM-AP angle and increased TIC-L were associated with an increased risk of relapse. Level of evidence: level III.

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“…In this context, some authors reported the involvement of lower limbs genetic mechanisms and possible influence on the development of tarsal bones [5]. Radiographic and sonographic studies on the development of tarsal bone shape in treated clubfeet revealed marked differences from normal feet but observed also some methodological difficulty in detecting morphological differences with these imaging modalities [6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Radiological tarsal bone morphology in adolescent age of congenital clubfeet treated with the Ponseti method

Hämel

Hörterer

Harrasser

2021

BMC Musculoskelet Disord

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Background Major abnormalities of tarsal bone shape after surgical clubfoot treatment are well known from the literature. The Ponseti method has gained widespread acceptance in primary treatment of congenital clubfeet. Despite the longtime experience, data regarding the development of tarsal bones after this treatment are still rare. The aim of the study was therefore to evaluate radiographic parameters describing tarsal bone shape of clubfeet after Ponseti treatment and compare them to age-matched healthy feet. Methods Twenty two consecutive severe clubfeet in 14 patients were investigated by repeated diagnostic ultrasound during the corrective process. Extent and temporal course of correction were documented with standardized X-rays after a mean follow-up of 12 years (between the ages of 10–14 years) and compared to a group of age-matched normal feet. Results Reliability testing for all X-ray parameters showed good to excellent results. In comparison to the control group, all parameters except the radius of the trochlea (RT) were significantly altered in clubfeet with highest differences shown for the anterior talar motion segment (ATM), talonavicular coverage (TNC) and the talometatarsal index (TMT-Index). Differentiation between minor and major deformities showed significant differences only for the front tarsal index (FTI). Conclusions Tarsal bone shape of clubfeet treated by the Ponseti method differs significantly from normal feet. One of the most pronounced and clinically relevant difference of the clubfoot talus compared to the normal talus is the markedly reduced anterior talar motion segment.

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Radiological study of anatomical bony arrangement of the clubfoot deformity and its correlation with the Pirani clinical scoring system: A multicenter study

Cited by 5 publications

References 18 publications

Outcomes of Eight‐Plate Epiphysiodesis for Residual Clubfoot Deformities

Outcomes of Eight‐Plate Epiphysiodesis for Residual Clubfoot Deformities

Are early antero-posterior and lateral radiographs predictive of clubfoot relapse requiring surgical intervention in children treated by Ponseti method?

Radiological tarsal bone morphology in adolescent age of congenital clubfeet treated with the Ponseti method

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