Value of the Fetal Plantar Shape in Prenatal Diagnosis of Talipes Equinovarus

Hui-fang, Liao; Cai, Ailong; Wang, Bing; Wang, Xiaoguang; Yan, Z.; Li, Jingyu

doi:10.7863/jum.2012.31.7.997

Cited by 8 publications

(9 citation statements)

References 15 publications

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“…The bimalleolar angle and bean–shape ratio were used to quantify the level of forefoot adduction. 2 , 24 , 25 The bimalleolar angle is the anteromedial angle which is formed between the bimalleolar axis and the longitudinal axis of the foot passing through the second toe. The bean–shape ratio assesses the curvature of the foot, thus quantifying forefoot adduction and hindfoot varus.…”

Section: Methodsmentioning

confidence: 99%

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Correcting Congenital Talipes Equinovarus in Children Using Three Different Corrective Methods

Chen

Yang

et al. 2015

Medicine

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Equinus, varus, cavus, and adduction are typical signs of congenital talipes equinovarus (CTEV). Forefoot adduction remains a difficulty from using previous corrective methods. This study aims to develop a corrective method to reduce the severity of forefoot adduction of CTEV children with moderate deformities during their walking age. The devised method was compared with 2 other common corrective methods to evaluate its effectiveness.A Dennis Brown (DB) splint, DB splint with orthopedic shoes (OS), and forefoot abduct shoes (FAS) with OS were, respectively, applied to 15, 20, and 18 CTEV children with moderate deformities who were scored at their first visit according to the Diméglio classification. The mean follow-up was 44 months and the orthoses were changed as the children grew. A 3D scanner and a high-resolution pedobarograph were used to record morphological characteristics and plantar pressure distribution. One-way MAVONA analysis was used to compare the bimalleolar angle, bean–shape ratio, and pressure ratios in each study group.There were significant differences in the FAS+OS group compared to the DB and DB+OS groups (P < 0.05) for most measurements. The most salient differences were as follows: the FAS+OS group had a significantly greater bimalleolar angle (P < 0.05) and lower bean–shape ratio (P < 0.01) than the other groups; the DB+OS and FAS+OS groups had higher heel/forefoot and heel/LMF ratios (P < 0.01 and P < 0.001) than the DB group.FAS are critical for correcting improper forefoot adduction and OS are important for the correction of equinus and varus in moderately afflicted CTEV children. This study suggests that the use of FAS+OS may improve treatment outcomes for moderate CTEV children who do not show signs of serious torsional deformity.

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Section: Methodsmentioning

confidence: 99%

“… 1 The deformity has 4 main components: equinus, varus, cavus, and adduction. 1 , 2 If the deformity is not corrected promptly, the ambulatory ability of children will be seriously affected. Nonoperative treatments are typically considered the first choice for treating CTEV in young children.…”

Section: Introductionmentioning

confidence: 99%

Correcting Congenital Talipes Equinovarus in Children Using Three Different Corrective Methods

Chen

Yang

et al. 2015

Medicine

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“…Three series have analysed the prenatal parameters that could predict postnatal severity of isolated clubfoot. [7][8][9] Glotzbecker et al 7…”

Section: Both Formentioning

confidence: 99%

“…Evaluation of the placenta and amniotic fluid is necessary to exclude the possibility of oligohydramnios being the cause of fetal malposition. 6 There have been reports in the literature of prenatal parameters that may help to identify severe cases of clubfoot, [7][8][9] but none of these have been incorporated into a routine evaluation of the fetal legs and feet. The purpose of this study is to identify a possible correlation between the prenatal description of isolated clubfoot and its degree of severity after birth.…”

Section: Introductionmentioning

confidence: 99%

Congenital isolated clubfoot: Correlation between prenatal assessment and postnatal degree of severity

et al. 2020

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Objective: Since prenatal diagnosis of isolated clubfoot has a false positive rate (FP) of 10%-40%, fetal parameters that might correlate with post-natal confirmation and grade of severity were investigated. Method: Retrospective analysis (2013-2019) of cases analysed with threedimensional multiplanar view. The following data were recorded: the angle between the long axis of foot and lower leg; width, length and width-to-length ratio (W/L) of the foot; tibia length and calf width (T/C) ratio. Severity after birth was assessed using the Pirani classification. Results: Diagnosis was confirmed in 45/53 neonates (84.9%, FP 15%). Values were higher for both angle and W/L in true vs false positive cases (median angle 100.4 versus 69.55 , p <.000; median W/L 0.53 vs 0.45, p = .001), no difference for T/C (3.77 vs 3.48, p = .8). The area under the curve for angle was 0.98 (CI 0.94-1.00), with a diagnostic cutoff of 84.7 (PPV of 100%, NPV of 66.7%). Median Pirani score, available for 33 neonates (73.3%) was 3 (IQR 3-4): only angle correlated with Pirani score (Spearman coefficient 0.36, p = .04) Conclusion: Measuring the angle between the foot and lower leg can reduce the FP rate of prenatal congenital clubfoot diagnosis and better predict the need for postnatal treatment.

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“…11 Anyway, regarding the clubfoot, ultrasound have proven to be the most reliable method of prenatal diagnosis. 9,10,15,18,[20][21][22][23][24] The ability of achieving prenatal diagnosis of clubfoot have increased during the past two decades from about 25% to over 80%. Reports about the risk of false-positive prenatal diagnosis during pregnancy are diverse: the rate of false-positive prenatal diagnosis vary widely from 0 to 40% in isolated clubfoot.…”

Section: Discussionmentioning

confidence: 99%

Prenatal Diagnosis of Clubfoot: A Review of Current Available Methodology

et al. 2017

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Background: Clubfoot is one of the most common congenital limb deformities. Prenatal diagnosis of the condition is essential as it can help treat the malformation as early as possible. We reviewed the recent available literature concerning the current methods for prenatal diagnosis of clubfoot. Methods:The following databases were searched from 1966 to 2015: PubMed, OVID, Cochrane, CINAHL, Google scholar and Embase. Results: Out of a total number of 197 retrieved articles, after abstract or title page evaluation, 158 articles not matching the inclusion criteria were excluded. The full text versions of the remaining 39 articles were obtained, and their reference lists screened, with the addition of another 5 full-text articles. Conclusions: Currently, ultrasonography is considered the most reliable method of prenatal diagnosis of clubfoot. Ultrasonographic diagnosis of clubfoot appears more likely between the 18th and the 24th week of pregnancy. Alternative imaging is not indicated. There is no agreement whether to propose foetal karyotyping when isolated clubfoot is diagnosed by prenatal ultrasonography. Early detection of clubfoot should prompt a careful surveillance during pregnancy in order to detect any possible additional abnormalities and, if any of these are detected, invasive testing should be off ered.

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Value of the Fetal Plantar Shape in Prenatal Diagnosis of Talipes Equinovarus

Cited by 8 publications

References 15 publications

Correcting Congenital Talipes Equinovarus in Children Using Three Different Corrective Methods

Correcting Congenital Talipes Equinovarus in Children Using Three Different Corrective Methods

Congenital isolated clubfoot: Correlation between prenatal assessment and postnatal degree of severity

Prenatal Diagnosis of Clubfoot: A Review of Current Available Methodology

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