Sonographic assessment of clubfoot.
OBJECTIVE
This study was performed to develop a standardized methodology for the sonographic assessment of clubfoot at birth and at the end of both conservative treatment and surgical correction.


METHODS
Forty-two congenital clubfeet and 42 normal feet were examined sonographically in the position of spontaneous alignment and during passive manual correction. Scans along 4 planes provided information relevant to the assessment: sagittal posterior, sagittal anterior, coronal lateral, and transverse.


RESULTS
Sagittal posterior sonograms demonstrated the progressive gain of dorsiflexion ability during the different steps of treatment for clubfoot. Sagittal anterior sonograms could not demonstrate the normal alignment of the navicular in clubfeet because of the bone's medial displacement. On transverse sonograms, the talar head and the medially displaced navicular may lie on the same plane, depending on the severity of the deformity. Coronal lateral sonograms provided for estimation of the relationships between the calcaneus and cuboid, which were described by the calcaneal-cuboid angle.


CONCLUSIONS
Sonography is a promising technique for assessment and monitoring of clubfoot during treatment. The method described here yields accurate and reproducible information about the anatomy of the nonossified clubfoot, helping the orthopedic team decide on appropriate treatment steps.
Gigante
Cosimo
C
Department of Pediatric Orthopedics, Padua University Hospital, Via Giustiniani, 3, 35128, Padua, Italy.
Talenti
E
E
Turra
S
S
D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D002111:Calcaneus / Q000000981:diagnostic imaging; D003025:Clubfoot / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D004838:Epiphyses / Q000000981:diagnostic imaging; D005260:Female; D005528:Foot / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011187:Posture; D011446:Prospective Studies; D016059:Range of Motion, Articular; D013628:Talus / Q000000981:diagnostic imaging; D013977:Tibia / Q000000981:diagnostic imaging; D014463:Ultrasonography