The ultrasonography evaluation of talar dysplasia as a potential prognostic factor for predicting the course and outcomes of clubfoot deformity treatment using Ponseti technique

Abstract

Objective: The aim of this study was to assess the role of sonographic evaluation of Talar dysplasia inpredicting the outcome of standard Ponseti method in the treatment of clubfoot deformity.Methods: A total 23 children (15 boys and 8 girls; mean age: 18.2± 5.4 days (8e32)) who underwentPonseti treatment were included in the study. Before the treatment, maximal talus length of affected andnon-affected feet were measured by US and relative talar dysplasia ratio (RTDR) was calculated. Thepatients were categorized 2 groups according to RTDR: group Ae mild and group B e severe deformity.Pirani score was used for clinical evaluation. The groups were compared in terms of number of theapplied casts, need of percutaneous tenotomy of Achilles tendon (AchT) and frequency of deformityrecurrence.Results: Pirani score was 4.46 for population (4.33 for group A; 4.54 for group B). Number of castssigniŞcantly differed between groups (p < 0.001) and positive correlation was found (r ¼ 0.851,p< 0.001). AchT was performed in 56% cases for group A and in 86% cases for group B; no statisticallysigniŞcant difference was obtained (p ¼ 0.162). Recurrence occurred in 2 patients belonging to group Bwithout signiŞcant difference compared to group A (p ¼ 0.502).Conclusion: Talar dysplasia assessment appeared as a promising prognostic factor for predicting theoutcome of the Ponseti technique in treatment of clubfoot deformity.Level of evidence: Level IV, diagnostic study.