Resistive index and peak systolic velocity for congenital talipes equinovarus: A color Doppler ultrasonography study

Abstract

Congenital talipes equinovarus (clubfoot) is a disease that is treated frequently in orthopedics clinics. Its incidence is 1-2 per 1,000 live births. [1] Cavus, adductus, varus, and equinus deformities are observed in clubfoot patients; [2] each of these contributes to various bone, muscle, vascular, and neurological problems. [3] Vascular deficiencies have been suggested as one of the underlying etiologies of clubfoot. Various studies using arteriography, [3] continuous wave Doppler ultrasonography (DU), [4] color Doppler ultrasonography (CDU), [2,4-6] and magnetic resonance image angiography [3,7] were performed to show arterial patterns in clubfoot patients. Deficiency of the anterior tibial artery and dorsalis pedis (dp) artery were demonstrated in 6.7-86% of patients. [4] Many researchers have reported that CDU is a reliable technique and can be used as a suitable alternative for arteriography. [1,8] Several CDU studies have been undertaken to investigate the arterial structures in clubfoot patients. In these studies, Objectives: This study aims to investigate whether resistive index (RI) and peak systolic velocity (PSV) are suitable parameters to determine if a clubfoot differs from feet of the normal population. Patients and methods: Fifty-four feet of 27 clubfoot patients (22 males, 5 females; mean age 30.4±16.3 months; range, 5 to 72 months) were included in this retrospective study conducted between December 2017 and January 2019. Twentyseven feet were conservatively treated, 19 had surgical treatment, and eight feet were healthy in patients with unilateral clubfoot. In addition, 22 feet of 11 normal controls (6 males, 5 females; mean age 33.4±15.3 months; range, 15 to 60 months) were studied. Color Doppler ultrasonography examinations were performed to evaluate the three major arteries of the leg and foot: dorsalis pedis (dp), tibialis posterior (tp), and popliteal (pop). Color filling, flow direction, spectral analysis, velocity, and RI were examined. Results: With the exception of the dp artery RI, the PSV and RI values for all arteries differed significantly from those of the control group. There were no significant differences among the conservative, surgical, and healthy groups, while there were significant differences between each of the treated groups and the control group. Tibialis posterior artery PSV and pop artery RI were the best parameters to identify clubfoot and the cutoff points were 54 cm/second and 0.77, respectively. Conclusion: Peak systolic velocity and RI may be accepted as important parameters for identification of clubfoot deformity. Tibialis posteriorartery PSV and pop artery RI are the bestdetailed parameters for this examination.

The evaluation of vascular flow in clubfoot: a resistive index and peak systolic velocity study

“…Bozkurt et al [20]. also investigated RI and PSV in clubfoot and defined RI and PSV in a heterogeneous group of clubfoot patients having 30.4 months mean age.…”

“…Bozkurt et al . [20] defined a new vascular parameter for clubfoot obtained from CDU; resistive index (RI). The RI is defined as the peak systolic velocity (PSV) and end-diastolic velocity (EDV) difference divided by the PSV (PSV−EDV/PSV); its value ranges from 0 to 1, and it demonstrates the decrement of arterial blood flow at the end of the diastolic period.…”

Using the modified Ponseti method to treat complex clubfoot: Early results

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Congenital talipes equinovarus (clubfoot) has an incidence of one to two per 1,000 live births and is among the most frequently treated orthopedic diseases. [1] The Ponseti method became the gold standard treatment for clubfoot worldwide after the 1990s. [2][3][4][5][6][7] However, the widespread use of the Ponseti method has made it clear that treatment results can vary.

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