title: Dynamic Adduction Angle of Forefoot Measured With a Novel Technique And Its Relationship With Functional Outcomes.
abstract: BACKGROUND
  Idiopathic clubfoot is commonly treated with the Ponseti method with the extent of invasive treatment involving tendon-Achilles lengthening. Forefoot adduction is a common complication in surgically treated clubfeet. Yet, no method has been described to measure dynamic (walking) forefoot adduction. The aim of this study was to assess the persistent pes adductus in children whose clubfeet were surgically treated using a dorsomedial soft tissue release and to find out correlations between forefoot adduction and clinical outcome measures.
  
  
  METHODS
  We analysed the dynamic adduction angle in 33 clubfeet using a pressure-sensitive foot platform and compared it to the healthy feet of an age- and weight-matched group of children without congenital foot deformities. The clinical outcome was analysed using the McKay score.
  
  
  RESULTS
  Mean dynamic adduction angle was 4.1o in the surgically corrected clubfeet, whereas it was 6.4° in unaffected feet of patients with unilateral clubfoot and 7.1o in control group. The McKay score were excellent in 1 patient, good in 5, average in 13, and fair in 4 of the 23 patients. There was no correlation between dynamic adduction angle and McKay score using paired t test (P > 0.05).
  
  
  CONCLUSIONS
  High occurrence of dynamic adduction angle in surgically treated clubfeet was detected. In conclusion, no correlation between forefoot adduction, dynamic forefoot adduction angle and clinical outcome measures within the study was observed.
authors.affiliation: Department of Orthopedic Surgery, Loma Linda University School of Medicine, Loma Linda, CA 25455 Barton Rd #102B Loma Linda, CA 92354.
authors.forename: Nirav Hasmukh
authors.initials: NH
authors.lastname: Amin
authors.affiliation: Department of Orthopedic Surgery, Drexel University College of Medicine, Resident in Orthopedic Surgery, Philadelphia, PA Broad and Vine Street Philadelphia, PA 19103.
authors.forename: Andre
authors.initials: A
authors.lastname: Jakoi
authors.affiliation: Drexel University College of Medicine, Philadelphia, PA Broad and Vine Street Philadelphia, PA 19103.
authors.forename: Volpi Ms
authors.initials: VM
authors.lastname: Alexander
authors.affiliation: Department of Orthopedic Surgery, Loma Linda University School of Medicine, Loma Linda, CA 25455 Barton Rd #102B Loma Linda, CA 92354.
authors.forename: Martin Joseph
authors.initials: MJ
authors.lastname: Morrison
authors.affiliation: Department of Orthopedic Surgery, New York University, New York, NY 301 East 17 Street New York, NY 10003.
authors.forename: Per
authors.initials: P
authors.lastname: Trobisch
keywords: clubfoot; congenital talipes equinovarus; equinovarus; talipes equinovarus