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Cleft feet. Proposals for a new classification based on roentgenographic morphology
1Orthopädische Universitätsklinik Kiel, Federal Republic of Germany.
Clinical Orthopaedics and Related Research
|September 1, 1990
Summary
This study classifies cleft feet based on metatarsal bone count, revealing a progression from minor deficiencies to monodactylous feet. The classification aids in understanding the spectrum of this congenital foot malformation.
Area of Science:
- Orthopedics
- Developmental biology
- Medical imaging
Background:
- Cleft foot is a congenital malformation with varying degrees of severity.
- Understanding its morphology is crucial for diagnosis and treatment planning.
Purpose of the Study:
- To classify cleft feet based on roentgenographic morphology.
- To establish a classification system for cleft foot deformities.
Main Methods:
- Analysis of roentgenographic morphology of 45 patient-derived and 128 literature-sourced cleft feet.
- Development of a classification system based on metatarsal bone count.
Main Results:
- A six-group classification system (Types I-VI) was established based on metatarsal bone number, ranging from five to one.
- Type I: five normal metatarsals; Type II: five partially hypoplastic metatarsals; Type III: four metatarsals; Type IV: three metatarsals; Type V: two metatarsals; Type VI: monodactylous foot.
- Additional forms identified include polydactylous and diastatic types.
- Cleft formation originates at the second or third ray, progressing distally to proximally and transversely from tibial to fibular.
- Defects are larger distally; synostoses occur at cleft margins; polydactyly and cross-bones are rare.
Conclusions:
- The proposed classification system effectively categorizes the spectrum of cleft foot deformities.
- Understanding the developmental pattern of cleft formation aids in characterizing the malformation.
- The classification provides a framework for further research and clinical management of cleft feet.