Role of Foot Abduction and Heel Angle in Equinus Correction in Idiopathic Clubfoot

Introduction. The purpose of this study was to determine whether foot abduction and heel angles have any influence on resultant equinus correction and whether hindfoot dorsiflexion can be predicted based on these parameters. Material and Methods. Twenty-four children with 39 unintervened idiopathic clubfeet who completed Ponseti’s casting and percutaneous Achilles tenotomy with satisfactory equinus correction (≥15°) were included. Measurements included foot abduction and heel angle at the beginning of cast treatment, pre-tenotomy, and post-tenotomy along with post-tenotomy hindfoot dorsiflexion. Statistical relationships were calculated using Pearson’s coefficients. Results. The changes in heel angle correlated better with post-tenotomy dorsiflexion achieved than changes in foot abduction. Pre-tenotomy foot abduction or heel angle did not have any statistically significant correlation with post-tenotomy dorsiflexion. Furthermore, there was a significant relationship between post-tenotomy foot abduction and post-tenotomy dorsiflexion. Conclusions. Changes in foot abduction and heel angle (from initial casting to pre-tenotomy measurement) statistically correlated to post-tenotomy hindfoot dorsiflexion achieved. Absolute degree measurements of pre-tenotomy abduction or heel valgus did not correlate with the post-tenotomy hindfoot dorsiflexion achieved. There was also significant correlation between post-tenotomy abduction and post-tenotomy hindfoot dorsiflexion. Correlation between post-tenotomy heel valgus and post-tenotomy hindfoot dorsiflexion was weak.

Levels of Evidence: Prognostic, Level II: Prospective study