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Ultrasound Helpful in Assessing Clubfoot

The results of treatment for children with clubfeet isn't always satisfactory to the parents. An inwardly curved foot called forefoot adduction may persist. This is the most common reason parents aren't happy with how the foot looks.

The exact cause of FFA isn't clear. It may be because the navicular bone is moved too much medially (shifted toward the other foot). The navicular bone is the bump you may feel along the top of your foot between the ankle and your forefoot.

In this study, ultrasound is used to view the position of the navicular in children three years old and older who have had surgery to correct clubfeet. Hand drawn imprints of the foot are also made with the child standing. The foot drawings can be used to measure the severity of the FFA. The researchers suspect the more displaced the navicular, the worse the FFA.

What they found was no relation between the navicular and FFA. They did find that the worse the FFA, the more dissatisfied parents were with the results. And they report that ultrasound is a good way to measure the position of the navicular.

Another study is needed to look at other bone displacement as a possible cause of FFA. Once the exact mechanism for FFA is discovered, then treatment to correct the problem may result in a better looking foot after clubfoot correction.

References: Henrik Wallander, MD, et al. No Association Between Residual Forefoot Adduction and the Position of the Navicular in Clubfeet Treated by Posterior Release. In Journal of Pediatric Orthopaedics. January/February 2007. Vol. 27. No. 1. Pp. 60-66.

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