Correlation between clinical outcome of surgically treated clubfeet and different radiological parameters

The goal of this study was to determine the relationship between the clinical outcome of surgically treated clubfeet and several radiological parameters. The talocalcaneal angle, talocalcaneal index, talo-first metatarsal angle and the calcaneo-first metatarsal angle were measured on anteroposterior and lateral radiographs of 54 children with 70 idiopathic clubfeet treated surgically between 2000 and 2004. Their age at surgery ranged from 4 to 23 months. These radiological parameters were compared with the clinical results. Follow-up was conducted after 24 to 69 months following surgery. Using the functional rating system of Laaveg and Ponseti, results were graded as excellent in 28.6% (20 feet), good in 40% (28 feet), fair in 17.1% (12 feet) and poor in 14.3% (10 feet). There was a statistically significant correlation between the clinical results and two angles: the talo-first metatarsal angle on the anteroposterior radiograph and the calcaneao-first metatarsal angle on the lateral radiograph. These two angles should be considered when designing an evaluation system of clubfeet.