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The Application of Ultrasonography in the Infantile Congenital Clubfoot

Author: DuanYanZuo
Tutor: BaiDeMing
School: Shanxi Medical
Course: Children outside the science
Keywords: infantile Clubfoot Congenital ultrasonography
CLC: R726.8
Type: Master's thesis
Year: 2011
Downloads: 5
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Abstract


Objective This study was designed to evaluate the applied value of ultrasonographyin the infantile congenital clubfoot (CCF) and to provide a reasonable basis forclinical examination. US can apparently show the more anatomic details in footdeformities so as to obtain principle for treatment and follow-up of congenitalclubfoot.Materials and Methods 24 patients (17 boys and 7 girls) diagnosed CCF byclinical characters. The feet of 12 healthy neonates were used for reference. Age rangefrom 5 days to 3 months; mean age 25±3days. These patients include unilateralclubfeet 14 and bilateral clubfeet 10.The 14 contralateral feet of patients with CCFwere used for reference.US studies were performed with muscular-skeletal scanning system（PHLIPS-IU22, Phillips,USA）,using an 8- to 15-MHz linear transducer up to theage of 4 months and a 5-to 8-MHz linear transducer from the age of 5 months, whileoperating with 5-to 17-MHz linear transducer actually.The US examinations were carried out using medial, lateral and dorsalprojections. We measured MM-N distance、MSTT、AMSTT in medial projections;C-C distance in lateral projections;TL in dorsal projections. And obtained the maininformation of the tarsal bones.Results The average value of MM-N distance、MSTT of the CCF were 4.6mm and11.6mm in the medial projections. The average value of C-C distance was 2.5mm inthe lateral projections. The average value of TL was 14.5mm in the dorsal projections.We performed the statistical analysis about the measurement results of all normal feetand clubfeet. There were significant differences between clubfeet and normal feet.The US manifestations of CCF:A).Bony changes:Typical characteristics include,besides rotational deviation of talus and calcaneus. The positional relationship of thecalcaneus to the ankle in clubfoot was characterized by its external rotation, thenavicular and cuboid bones as well as internal deviations to the talus and calcaneus.Medial displacement of the navicular in relation to the head of the talus or medialnavicular alignment (NAL m) was scored subjectively according to four grades in which 1 = no displacement, 2 = less than 50% medial navicular displacement, 3 =greater than 50% displacement, and 4 = complete navicular subluxation.B).cartilaginous changes: The development of ossification center in CCF wasmore delayed compared with normal feet, and ossification position was oftendeformed, small, and eccentrically located, especially in the talus. The length of taluswas shorter than normal feet. Hyaline cartilage appears black with white dots inprojections, whereas the articular cartilage is totally black.ConclusionConclusions US can clearly visualize both the ossification centers andsurrounding cartilage of growing bones. US can be used for evaluate pathologicalchanges of CCF in details and choosing reasonable treatment for clinical therapy. It isa useful imaging modality for assessing the bony, cartilaginous and soft-tissuestructures in the infantile clubfoot. In the procedure of treatment and follow-up, US isan excellent tool in the assessment of CCF.

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CLC: > Medicine, health > Pediatrics > Pediatric surgery > Pediatric bone science
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