Vatsa Gaurav, Suman Saurabh, Singh Siddharth Kumar
Department of Orthopaedics, Narayan Medical College and Hospital, Sasaram, Bihar, India.
J Orthop Case Rep. 2025 Jul;15(7):262-267. doi: 10.13107/jocr.2025.v15.i07.5844.
Congenital talipes equinovarus (CTEV), or clubfoot, is a common congenital lower limb disorder. Pre-natal diagnosis using ultrasound (US) enables early identification, facilitating timely intervention and improving outcomes. Understanding the diagnostic accuracy and implications of pre-natal CTEV detection is essential for effective clinical management.
This observational cohort study evaluated pre-natal US accuracy in detecting CTEV. Two thousand singleton pregnancies between 18 and 24 weeks of gestation were included. Exclusions applied to complicate and multiple pregnancies. Participants underwent anomaly scans, with fetal lower limbs assessed for clubfoot indicators. Follow-up included post-natal examinations and Pirani scoring for confirmed cases. Diagnostic accuracy metrics, including sensitivity, specificity, and predictive values, were calculated.
Among live births, pre-natal US identified CTEV cases, with final confirmation distinguishing structural from positional deformities. The study found high sensitivity and specificity, reinforcing US's reliability for early detection. All affected cases were successfully treated using the Ponseti method, avoiding surgical intervention.
Despite its effectiveness, US remains operator-dependent, necessitating standardized protocols to reduce misdiagnosis. Early detection benefits psychological preparedness and treatment planning. Future research should assess long-term functional outcomes and optimize pre-natal screening protocols, particularly in resource-limited settings, to ensure comprehensive CTEV management.
先天性马蹄内翻足（CTEV），即马蹄足，是一种常见的先天性下肢疾病。使用超声（US）进行产前诊断能够实现早期识别，便于及时干预并改善治疗效果。了解产前CTEV检测的诊断准确性及意义对于有效的临床管理至关重要。
这项观察性队列研究评估了产前超声检测CTEV的准确性。纳入了2000例妊娠18至24周的单胎妊娠。排除适用于复杂和多胎妊娠。参与者接受了畸形扫描，对胎儿下肢进行马蹄足指标评估。随访包括产后检查以及对确诊病例进行皮拉尼评分。计算了诊断准确性指标，包括敏感性、特异性和预测值。
在活产儿中，产前超声识别出CTEV病例，最终确诊区分了结构性畸形和姿势性畸形。研究发现敏感性和特异性较高，增强了超声早期检测的可靠性。所有受影响的病例均成功采用庞塞蒂方法进行治疗，避免了手术干预。
尽管超声有效，但它仍然依赖操作者，需要标准化方案以减少误诊。早期检测有利于心理准备和治疗规划。未来的研究应评估长期功能结局并优化产前筛查方案，尤其是在资源有限的环境中，以确保对CTEV进行全面管理。
