الفهرس | Only 14 pages are availabe for public view |
Abstract The present study was undertaken to evaluate, clinically and sonographically, the reliability of the Ponseti method in correcting clubfeet, and to determine whether a correlation exist between different U/S variables and whether a correlation exist between these variables and the pirani score before and after treatment. Twenty children with clubfeet were used in this prospective study (12 unilateral and 8 bilateral). A control group of 6 infants was studied. The other normal foot of the unilateral clubfoot was also used in this study as control. All clubfeet cases were clinically assessed using pirani scoring system at the first and last visit during the Ponseti treatment of serial manipulation and casting for six visits. For ultrasonographic assessment, all clubfeet were assessed at the first and last visit during treatment procedure. It was performed with 4D mxf Philips ultrasonography machine. The following projections and measurement were taken : i. Medial projection : 1- Medial malleolus navicular distance (MM-N). 2- Medial soft tissue thickness (MSTT). ii. Lateral projection : Calcaneocuboid angle (C-CU). iii. Posterior projection: Tibio-calcaneal distance (T-C). The following data were obtained : The mean U/S measurements of control infants : Medial malleolus-navicular distance (MM-N) was equal to 11.1 ± 0.29 mm; Medial soft tissue thickness (MSTT) was equal to 10.1 ± 0.28 mm; Calcaneocuboid angle (C-CU) was equal 8.4 ± 0.12º; Tibio-calcaneal distance (T-C) was equal to 13.2 ± 0.57 mm. The mean pretreatment U/S measurements of clubfoot infants : Pirani score was equal to 5.2 ± 0.37; Medial malleolus-navicular distance (MM-N) was equal to 4.6 ± 0.35 mm; Medial soft tissue thickness (MSTT) was equal to 10.98 ± 0.36 mm; Calcaneocuboid angle (C-CU) was equal 17.9 ± 0.54º; Tibio-calcaneal distance (T-C) was equal to 9.8 ± 0.26 mm. |