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The pulseless club foot.

J G Edelson, N Husseini

    The Journal of Bone and Joint Surgery. British Volume
    |November 1, 1984
    PubMed
    Summary

    Doppler studies in children with club feet show reduced anterior tibial artery pulses are less common than previously thought. Pulselessness increases with deformity severity and duration, but not as drastically as prior angiographic reports suggested.

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    Area of Science:

    • Orthopedics
    • Vascular Surgery
    • Pediatric Medicine

    Background:

    • Previous studies indicated absent or diminished anterior tibial artery blood supply in severe club feet.
    • Angiographic reports suggested an 85% incidence of this vascular anomaly.

    Purpose of the Study:

    • To investigate the prevalence of absent or diminished anterior tibial artery pulses in children with club feet using Doppler ultrasound.
    • To compare Doppler findings with previous angiographic reports on club foot vascularity.

    Main Methods:

    • Doppler ultrasound was employed to assess arterial pulses in 63 club feet across 40 children.
    • Patients were categorized by club foot severity (mild, moderate, severe) and age (under and over three years).

    Main Results:

    • Anterior tibial pulses were consistently present in mild and moderate club feet.
    • In severe club feet, pulselessness was observed in 2/30 children under three and 7/18 children over three.
    • The incidence of pulselessness correlated with deformity severity and duration, but was lower than previously reported.

    Conclusions:

    • The study confirms an increased incidence of absent anterior tibial pulses with greater club foot severity and duration.
    • Doppler findings suggest the vascular compromise is less prevalent than indicated by earlier angiographic studies.
    • These findings have implications for understanding the pathophysiology and treatment of congenital club foot.

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