Li Jingchun,Xu Chenchen,Li Yiqiang,et al.Characteristics of talus-calcaneus angel on lateral radiograph of congenital clubfoot after Ponseti method and its predictive value for recurrence[J].Journal of Clinical Pediatric Surgery,,21():714-718.[doi:10.3760/cma.j.cn101785-202205068-003]
Characteristics of talus-calcaneus angel on lateral radiograph of congenital clubfoot after Ponseti method and its predictive value for recurrence
- Keywords:
- Equinus Deformity/DG; Talus/AB; Calcaneus/AB; Recurrence; Forecasting
- Abstract:
- Objective To explore the characteristics of lateral talus-calcaneus angle on early radiographic examination of congenital clubfoot after Ponseti treatment and assess the clinical value of predicting the relapse of clubfoot.Methods Between January 2002 and September 2013,medical records were reviewed for 119 children with congenital clubfoot in 177 feet.They were divided into two groups of non-recurrent and recurrent according to the follow-up outcomes.The age of initial treatment was all under 6 months.Series of cast and achilles tendon release after Ponseti method were employed for correcting the deformity.Early radiographic examination of foot was performed within 3 months after Achilles tendon release.The authors compared lateral talus-calcaneus angle (TC_L) between normal foot and clubfoot in unilateral cases and compared the characteristics of TC_L between non-recurrent and recurrent cases.Also the relationship was examined between TC_L and prognosis of clubfoot for determining the value of initial TC_L in predicting the recurrence of clubfoot.Results No significant difference existed in gender,age of Achilles tendon release and age of radiographic examination (P=0.83,P=0.57,P=0.17).TC_L of initial radiographic examination differed markedly between two groups[(34.38±10.99°)vs.(40.72±12.86°),P<0.001].TC_L was significantly different between clubfoot and normal foot[(38.56±11.57°)vs.(50.91±9.26°),P<0.001].Logistic regression indicated that the area under the curve of receiver operating characteristic (ROC) was 0.6629(χ2=8.2567,P=0.0041) in predicting recurrence of clubfoot using a TC_L.cutoff value of 40°.The diagnostic specificity and sensitivity was 61.11% and 68.09% respectively.Conclusion TC_L on early radiography within 3 months after achilles tendon release is less than that in normal foot.TC_L offers some values in the prediction of recurrence after treatment.The smaller TC_L,the more likely to be relapsing with a cutoff value of 40°.
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Memo
收稿日期:2022-5-23。
基金项目:广州市妇女儿童医疗中心/广州市儿科研究所内部基金(0170018)
通讯作者:徐宏文,Email:xuhongwen@gwcmc.org