Correlation between foot bimalleolar angle and clinical outcome in surgically treated resistant congenital talipes equinovarus

Abstract

The evaluation of clubfoot should be undertaken mainly on the clinical basis because many studies have shown no consistent relationship between radiographic appearance and the functional outcome in the evaluation of clubfoot. Foot bimalleolar angle (FBM) is a simple, objective and reproducible criterion that can be used to evaluate the results of treatment. This study was done to establish the normal FBM angle on foot tracing of normal Jordanian population, to calculate FBM angle in resistant congenital talipes equinovarus (CTEV) before and after surgery and to correlate it with the clinical results. The FBM angle of 200 feet in 100 normal infants (50 male and 50 female) ranging in age from 1 month to 12 months was determined. In a 15 year period (1988-2003), 102 (72 male, 30 female) out of 215 patients with resistant clubfeet who were treated surgically in Princess Basma Teaching Hospital and King Abdullah University Hospital (KAUH), Irbid-Jordan, were available at the final follow up visit. The patients were divided according to the type of surgical correction into 2 groups: the first group consisting of 60 patients (75 clubfeet) were treated by complete subtalar release as described by Simons. The second group consisting of 42 patients (50 clubfeet) were treated by Turco posteromedial release. At the latest follow up FBM angle for the 2 groups was determined. Clinical evaluation of the 2 groups correlated well with FBM angle.