Noninvasive vascular studies in clubfoot.
A two-phase study investigated vascularity in idiopathic clubfeet (talipes equinovarus, TEV) undergoing a comprehensive soft tissue release. Great toe O2 saturation was measured by pulse oximetry in a consecutive series of 50 TEV (34 patients) in three foot positions: in feet at rest, in feet in maximal passive correction, and in feet immediately postoperatively. Oxygen saturation was between 94 and 100% in 100% of feet at rest, 95-100% in 90% of feet at maximal passive correction, 95-100% in 98% of feet immediately postoperatively, and 97-100% in 100% of feet 3 weeks' postoperatively. Doppler ultrasound studies were performed on 38 TEV. Dorsalis pedis (DP), posterior tibial (PT), and peroneal (P) pulses were recorded at preoperative resting posture, preoperative maximal passive correction, and 3 weeks postoperatively. At rest, DP pulse was present in 37 of 38 feet, PT pulse was present in all feet, and P pulse was present in 20 of 30 tested (67%), whereas 72% PT, 61% DP, and 50% P pulses were unchanged. Pulse oximetry and Doppler assessment are readily available, noninvasive, and reproducible means of monitoring vascular integrity in TEV.
Stanitski
C L
CL
Department of Orthopaedic Surgery, Children's Hospital of Pittsburgh, Pennsylvania.
Ward
W T
WT
Grossman
W
W
D003025:Clubfoot / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D005528:Foot / Q000098:blood supply*; D006214:Hallux / Q000098:blood supply; D006801:Humans; D007223:Infant; D008297:Male; D010092:Oximetry; D011184:Postoperative Period; D011674:Pulse; D012039:Regional Blood Flow