title: Ultrasound assessment of early clubfoot treatment: a comparison of the Ponseti method and a modified Copenhagen method.
abstract: The purpose of this study was to sonographically compare the early anatomical outcome of a group of clubfeet treated with the Ponseti method (group A, nine clubfeet) with a group treated with an adjustable plexidur splint, the Copenhagen method (group B, 19 feet). The clinical severity was assessed using the Diméglio-Bensahel classification. The need for complementary surgery was clinically assessed at the age of about 2 months. Ultrasound investigation was made in the neonatal period, after 2-3 months of non-surgical treatment and 1-2 months post-surgically. After 2 months of non-surgical treatment the correction obtained at the talo-navicular joint, expressed as the distance between the medial malleolus and the navicular (MM-N distance), was significantly greater in group A. After surgery, tenotomy of the Achilles tendon for all group A feet, and posterior or posteriomedial release for 13 feet in group B, the correction at the talo-navicular and calcaneo-cuboid joints was similar for the two groups. Anatomical correction of the displacement in these joints can be achieved without extensive interventional procedures. Ultrasound may be a valuable tool to assess the effects of different treatment protocols quantitatively.
authors.affiliation: Department of Diagnostic Radiology, Halmstad County Hospital, Halmstad, and Department of Orthopaedics, Lund University Hospital, Lund, Sweden. ylva.aurell@lthalland.se
authors.forename: Ylva
authors.initials: Y
authors.lastname: Aurell
authors.forename: Hanneke
authors.initials: H
authors.lastname: Andriesse
authors.forename: Arne
authors.initials: A
authors.lastname: Johansson
authors.forename: Kjell
authors.initials: K
authors.lastname: Jonsson
mesh_terms: D000125:Achilles Tendon / Q000601:surgery; D002370:Casts, Surgical; D003025:Clubfoot / Q000000981:diagnostic imaging* / Q000628:therapy*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008349:Manipulation, Orthopedic / Q000379:methods*; D012720:Severity of Illness Index; D013165:Splints; D013640:Tarsal Joints / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D014463:Ultrasonography