Noninvasive vascular studies in clubfoot

A two-phase study investigated vascularity in idiopathic clubfeet (talipes equinovarus, TEV) undergoing a comprehensive soft tissue release. Great toe O2 saturation was measured by pulse oximetry in a consecutive series of 50 TEV (34 patients) in three foot positions: in feet at rest, in feet in maximal passive correction, and in feet immediately postoperatively. Oxygen saturation was between 94 and 100% in 100% of feet at rest, 95-100% in 90% of feet at maximal passive correction, 95-100% in 98% of feet immediately postoperatively, and 97-100% in 100% of feet 3 weeks' postoperatively. Doppler ultrasound studies were performed on 38 TEV. Dorsalis pedis (DP), posterior tibial (PT), and peroneal (P) pulses were recorded at preoperative resting posture, preoperative maximal passive correction, and 3 weeks postoperatively. At rest, DP pulse was present in 37 of 38 feet, PT pulse was present in all feet, and P pulse was present in 20 of 30 tested (67%), whereas 72% PT, 61% DP, and 50% P pulses were unchanged. Pulse oximetry and Doppler assessment are readily available, noninvasive, and reproducible means of monitoring vascular integrity in TEV.