Clinical and Ultrasonographic (USG) assessment and their correlation in clubfoot treated with ponseti cast
Journal Title: International Journal of Orthopaedics Sciences - Year 2017, Vol 3, Issue 3
Abstract
Background: Congenital talipes equinovarus (clubfoot) is a common foot deformity in children affecting 1/1000 live births. Pirani scoring system is used mainly for clinical assessment. To correlate the success, reported with Ponseti method an imaging modality is required to quantitate the deformity. Sonography being a radiation free, easily available non-invasive imaging has been investigated for this purpose. The aim of our study is to correlate clinical and sonographic parameters in various grades of clubfoot. Materials and methods: 53 clubfeet in 34 infants with a mean age of 2.43 ± 1.97 months were examined clinically using Pirani score. Sonographic examination was done in medial, lateral and posterior projection in affected feet. The sonographic parameters measured were: Medial Malleolar Navicular distance (MMN), Calcaneo-cuboid angle (CC angle) and Tibio-calcaneal distance (TC). Treatment was done with Ponseti method of serial manipulation and casting. Weekly assessment was done clinically by Pirani scoring and various Ultrasonographic parameters. Pirani score were correlated with Ultrasonographic parameters. Results: Out of 53 clubfeet, 19 were bilateral and 15 were unilateral with male: female ratio of 1.8: 1. There was progressive decrease in Pirani score and C-C angle, and progressive increase in MMN distance and T-C distance during treatment. A strong negative correlation was found between mean Pirani score and mean MMN distance, and between mean Pirani score and T-C distance. A strong positive correlation was found between mean Pirani score and C-C angle. Conclusion: Sonography should be as a supplement to clinical assessment of clubfoot, as it is cheap, easily available and being non-invasive can be repeatedly performed, and can help to determine any spurious correction during course of treatment.
Authors and Affiliations
Dr. Arijit Dhar, Dr Arup Kumar Daolagupu, Gaurav Khanted
Keywords
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- EP ID EP498010
- DOI 10.22271/ortho.2017.v3.i3d.42
- Views 100
- Downloads 0
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