CORRELATION OF RADIOLOGICAL PARAMETERS WITH CLINICAL OUTCOME OF CLUBFOOT TREATED WITH PONSETI METHOD

Main Article Content

Dr. Sudeep Madhukar Nambiar
Dr. Viplav Shetty
Dr. Ramvivek V.M.
Dr. Gandi Adinarayana Roy
Dr. Nagakiran K.V.
Dr. Vyshnavi J.M.
Dr. Sheshachala S.

Keywords

Congenital talipes equinovarus, Midfoot score (MS), Hindfoot score (HS), Talocalcaneal angle-Anterioposterior view(TCA-AP), Talo 1st metatarsal angle –Anterior-posterior view (TMT-AP), Lateral: Talocalcaneal angle-Lateral view (TCA), Lateral: Tibiocalcaneal angle-Lateral view (TiC), Talocalcaneal index (TCI), Magnetic Resonance Imaging (MRI), Computed Tomography (CT), DB splint: Denis Browne splint

Abstract

Background: Congenital talipes equinovarus also known as clubfoot is one of the most common congenital orthopedic conditions. Currently, the Ponseti plaster method is the gold standard for the treatment of clubfoot, which involves weekly manipulation and plaster application. The role of radiological parameters in the evaluation and treatment of CTEV (Congenital talipes equinovarus) is still controversial. The study aims to evaluate the correlation of radiological parameters with the clinical outcome of clubfoot treated with the Ponseti method.


Methods: This study was conducted with 40 feet in 30 patients with idiopathic from January 2021 to July 2022. The Pirani scoring system was used for clinical evaluation.


Results: The anteroposterior view was scored for talocalcaneal angle and first metatarsal talo angle, while the lateral view was scored for talocalcaneal angle and tibiocalcaneal angle. The mean initial total Pirani score was 5.5 which decreased to 0.9. The mean initial talocalcaneal angle in anteroposterior and lateral views was 19.7 and 24.5, increasing to 41 and 38.1 after correction. The mean talocalcaneal index increased from 22.1 before correction to 39.5 after correction. The mean talo-first metatarsal angle in the anteroposterior view improved from 28.1° before correction to -13.3° after correction. The relationship between the differences in Pirani scores at the first visit and after correction and the differences in radiographic parameters at the first visit and after correction revealed a statistically significant correlation.


Conclusion: Radiographic parameters showed a statistically insignificant correlation with the clinical outcome. Thus, evaluation of clubfeet correction treated by the Ponseti technique can rely mainly on clinical scores

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