Antenatal sonographic diagnosis of club foot with particular attention to the implications and outcomes of isolated club foot

Abstract

Most cases of antenatally diagnosed club foot were not isolated. Even when they were thought to be isolated on antenatal ultrasound, over half of them were later found to be associated with additional severe abnormalities that were detectable only in the neonatal period.

Prenatal Diagnosis of Clubfoot: A Review of Current Available Methodology

“…The embryonic and foetal foot are reported to develop in two phases, the fi bular (6.5 -7 gestation weeks) and the tibial (8 -9 gestation weeks). 19 During these two stages of development, the foot passes through three positions: at fi rst it is located in a straight line with the leg (initial position); subsequently it is posed in a marked position of equinovarusadduct (embryonic phase), and finally, around the 11th week of gestation, it assumes its fi nal physiological position (foetal phase). 7 If any foot alterations are observed at an earlier stage, a tight compulsory ultrasound control becomes necessary before the fi nal diagnosis of clubfoot.…”

“…Ultrasound analysis is therefore unable to assist the paediatric orthopaedic surgeon in prenatal counselling. 19 Nevertheless, Pullinger et al recently reported that clubfoot found on fetus between the 18th and the 20th week of pregnancy with ultrasonography scans will develop a structural deformity requiring treatment in 81% of the cases. 29 Ultrasound examination is undoubtedly considered the only effective screening examination during the entire period of gestation.…”

“…Rijhsinghani et al 19 studied seven of 35 patients with isolated clubfoot. Follow-up beyond their fi rst year of life revealed that three of seven cases developed other abnormalities, previously not suspected in the foetal period.…”

Congenital Fiber-Type Disproportion Presenting Antenatally with Clubfoot and Hydramnios

“…We have previously reported that antenatal diagnosis of isolated clubfoot can often be associated with later antenatal or postnatal findings of neuromuscular disorders [1]. Clubfoot has also been described in association with multiple congenital abnormalities including hydrolethalus syndrome, myotonic dystrophy [2], and trisomy 18 [1,3].…”

“…Clubfoot has also been described in association with multiple congenital abnormalities including hydrolethalus syndrome, myotonic dystrophy [2], and trisomy 18 [1,3]. Many of these conditions have also been associated with hydramnios [2,3].…”