Reliability of Clinical Features in Identifying Atypical Club Foot

Area of Science:

• Orthopedics
• Pediatric Surgery
• Medical Diagnostics

Background:

• Atypical clubfeet present unique challenges, often resisting standard Ponseti manipulations.
• Identifying specific clinical features aids in tailoring treatment for optimal outcomes.
• This study focuses on atypical clubfeet, distinct from idiopathic cases.

Purpose of the Study:

• To assess the prevalence of clinical features in atypical clubfeet.
• To evaluate the influence of these features on the modified Ponseti management protocol.
• To correlate clinical findings with the number of casts required for correction.

Main Methods:

• Fifty-two atypical clubfeet were evaluated for distinct clinical signs.
• Patients were treated using a modified Ponseti casting technique.
• The number of casts needed was correlated with observed clinical features.

Main Results:

• Short hyperextended great toe (smaller than the 2nd toe) was universally present.
• Deep plantar crease and short, swollen foot were observed in over 90% of cases.
• The mean number of casts was 8.8, increasing with the presence of additional clinical features.

Conclusions:

• Short hyperextended great toe, short swollen foot, and deep plantar crease are key indicators of atypical clubfeet.
• Treatment of atypical clubfeet requires more casts than idiopathic cases.
• The complexity and number of casts increase with each additional identified clinical feature.