Relationship of Talar Dome Changes with Ankle Mobility in Conservatively Treated Idiopathic Congenital Equino-Varus Foot
Abstract
Introduction: The Ponseti technique (PT) is widely used for managing idiopathic congenital talipes equinovarus (CTEV), but it can lead to talar dome distortion and reduced ankle range of motion (ROM), resulting in compromise functional outcomes. This study aimed to evaluate talar distortion in children treated with the Ponseti method and explore the relationship between static ankle movement and talar distortion, using the radius-to-length (R/L) ratio.
Materials and methods: A prospective observational study was conducted involving 25 children aged 5 to 15 years with unilateral idiopathic CTEV, all of whom had achieved correction with the Ponseti method by the age of one. Detailed clinical histories, functional assessments, and radiographic evaluations were performed. The R/L ratio of the talus was calculated and correlated with ankle ROM, number of casts, number of tenotomies, and the Ponseti and Laaveg score.
Results: Talar dome distortion was observed in 64% of cases. A significant negative correlation was found between the treated foot's R/L ratio and its ankle ROM (Spearman’s ρ = -0.634, p = 0.001), as well as with the Ponseti and Laaveg scores (Spearman’s ρ = -0.533, p = 0.006). A positive correlation was identified between the R/L ratio and the number of casts applied (Spearman’s = 0.417, p = 0.038). A statistically significant difference in both ROM and R/L ratio was noted between the treated and unaffected feet.
Conclusion: Talar Dome distortion is present in conservatively managed CTEV feet. There is also a significant negative correlation between R/L ratio, ankle ROM and Ponseti and Laaveg score.
Abstract | Reference
