Real time evaluation of monolateral clubfoot with sonoelastography

This study was undertaken to assess the feasibility of real-time elastosonography (RTE) of Achilles tendon in the clinical evaluation of a cohort of children affected by unilateral clubfoot, not surgically treated.

Twenty patients affected by unilateral clubfoot were evaluated. The study group consisted of 8 males and 12 females (mean age, 16 ± 7.3 months), all treated with the Ponseti method. Children were divided into two groups according to age: group 1 aged 0-18 months, and group 2 aged 18-60 months. Any further systemic pathological conditions were considered exclusion criteria. For each subject, RTE examination of the Achilles tendons was performed bilaterally, and then regions of interest (ROIs) were positioned.

In children aged 0-18 months, the mean value ROI 1/mean value ROI 2 ratio was 2.0 ± 0.18 and it showed a statistically significant difference if compared to the same ratio from healthy tendons, 2.5 ± 0.17 (p < 0.05). In group 2 (children aged 18-60 months) the mean ROI 1/mean value ROI 2 ratio value was 1.8 ± 0.27, compared to a 2.04 ± 0.21 (p < 0.05) ratio in healthy tendons.

RTE is a feasible, reliable and easily performed technique that allows an accurate study of the mechanical properties of Achilles tendon in children with clubfoot.