Coley Brian D, Shiels William E, Kean John, Adler Brent H
Children's Radiological Institute, Department of Radiology, Columbus Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.
Pediatr Radiol. 2007 Nov;37(11):1125-9. doi: 10.1007/s00247-007-0601-3. Epub 2007 Sep 11.
US shows promise in evaluating clubfeet. In order to assess responses to therapy, the measurements of normal feet and clubfeet must be known.
To investigate the role of US measurement in quantitatively evaluating normal feet and clubfeet in children, and to assess changes in these feet with age.
Patients <1 year old with unilateral or bilateral clubfoot deformity underwent US examination of the foot with specific attention to the medial malleolar to navicular (MMN) distance. Measurements were made in neutral and full adduction positions, and in the abduction position simulating the Ponseti maneuver. Children undergoing US for other reasons had the same imaging performed and served as controls.
A total of 127 feet in 66 children were evaluated (20 children had bilateral clubfeet, 25 had unilateral clubfoot, and 21 had normal feet). Clubfeet had significantly (P < 0.001) lower MMN measurements at all three positions than control feet. These distances increased with patient age for both normal feet and clubfeet, but the rate of increase was less for clubfeet.
Normal feet and clubfeet exhibit marked differences in MMN distances, as well as differences in rate of change over time. By understanding the age-dependent variability of normal feet and clubfeet, dynamic sonography can help assess clubfoot anatomy and could help to assess the effect of treatment interventions.
超声在评估马蹄内翻足方面显示出前景。为了评估治疗反应，必须了解正常足和马蹄内翻足的测量值。
探讨超声测量在定量评估儿童正常足和马蹄内翻足中的作用，并评估这些足部随年龄的变化。
对年龄小于1岁的单侧或双侧马蹄内翻足畸形患者进行足部超声检查，特别关注内踝至舟骨（MMN）的距离。在中立位、完全内收位以及模拟庞塞蒂手法的外展位进行测量。因其他原因接受超声检查的儿童进行相同的成像检查并作为对照。
共评估了66名儿童的127只足（20名儿童为双侧马蹄内翻足，25名儿童为单侧马蹄内翻足，21名儿童为正常足）。在所有三个位置，马蹄内翻足的MMN测量值均显著低于对照足（P < 0.001）。正常足和马蹄内翻足的这些距离均随患者年龄增加，但马蹄内翻足的增加速率较小。
正常足和马蹄内翻足在MMN距离上表现出明显差异，以及随时间变化率的差异。通过了解正常足和马蹄内翻足的年龄依赖性变异性，动态超声检查有助于评估马蹄内翻足的解剖结构，并有助于评估治疗干预的效果。
