Can immediate postoperative radiographs predict outcomes in pediatric clubfoot?  

作　　者：Duangjai Leeprakobboon 

机构地区：[1]Department of Orthopedic,Khon Kaen Hospital,Muang 40000,Khon Kaen,Thailand

出　　处：《World Journal of Orthopedics》2022年第11期986-992,共7页世界骨科杂志（英文版）

摘　　要：BACKGROUND The goal of treatment for pediatric idiopathic clubfoot is to enable the patient to comfortably walk on his or her soles without pain.However,currently accepted treatment protocols are not always successful.Based on the abnormal bone alignment reported in this disease,some studies have noted a correlation between radiographic characteristics and outcome,but this correlation remains debated.AIM To assess the correlation between immediately postoperative radiographic parameters and functional outcomes and to identify which best predicts functional outcome.METHODS To predict the outcome and prevent early failure of the Ponseti’s method,we used a simple radiographic method to predict outcome.Our study included newborns with idiopathic clubfoot treated with Ponseti’s protocol from November 2018 to August 2022.After Achilles tenotomy and a long leg cast were applied,the surgeon obtained a single lateral radiograph.Radiographic parameters included the tibiocalcaneal angle(TiCal),talocalcaneal angle(TaCal),talofirst metatarsal angle(Ta1st)and tibiotalar angle(TiTa).During the follow-up period,the Dimeglio score and functional score were examined 1 year after surgery.Additionally,recurring events were reported.The correlation between functional score and radiographic characteristics was analyzed using sample and multiple logistic regression,and the optimal predictor was also identified.RESULTS In total,54 feet received approximately 8 manipulations of casting and Achilles tenotomy at a mean age of 149 days.The average TiCal,TaCal,Ta1st,and TiTa angles were 75.24,28.96,7.61,and 107.31 degrees,respectively.After 12 mo of follow up,we found 66%excellent-to-good and 33.3%fair-to-poor functional outcomes.The Dimeglio score significantly worsened in the poor outcome group(P value<0.001).Tical and TaCal showed significant differences between each functional outcome(P value<0.05),and the TiCal strongly correlated with outcome,with a smaller angle indicating a better outcome,each 1 degree decrease improved the funct

关 键 词：Idiopathic clubfoot RADIOGRAPH Functional outcome TENOTOMY Prognostic Tibiocalcaneal angle 

分 类 号：R726.8[医药卫生—儿科]