[Arterial blood flow in congenital idiopathic clubfoot].

A doppler ultrasound study investigated vascularity in congenital idiopathic clubfeet (talipes equinovarus, (TEV) pretreated only by casting and physiotherapy. The studies were performed on 40 TEV (27 patients) aged 4-72 months (average 15.1). In 12 unilateral cases of TEV, the opposite normal foot and 74 normal feet of 37 healthy children aged 3-35 months (average 8.7) were used as controls. Dorsalis pedis (DP), posterior tibial (PT), and peroneal (P) pulses were recorded by an unidirectional 8 MHZ continuous wave technique. At rest, DP pulses and PT pulses were present in all investigated TEVs. P pulse was absent in only one case of TEV. In the group of controls DP pulse was absent in one case and P pulse was absent in an other case of normal foot with contralateral TEV. All the other pulses in normal feet were present at physiological location. We propose that a vascular etiology for the origin of congenital idiopathic clubfoot, as reported in literature, is unlikely. The influence of postnatal casting in TEV on the vascular arterial condition is slight or even absent. Doppler assessment is readily available, noninvasive, and a reproducible mean of monitoring vascular integrity in clubfeet. Relating to vascular complications after surgery, perhaps caused by a preextant arterial anomaly, doppler assessment is indicated routinely in syndromes of multiple malformations with clubfoot deformity before surgical treatment. In congenital idiopathic clubfeet it is not necessary as a routine check.