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Observation
9%
149/1725
Serial casting
54%
934/1725
Manipulation under anesthesia followed by a single casting
2%
26/1725
Surgical re-alignment
3%
49/1725
Serial manipulation and casting followed by surgical release and talonavicular reduction with pinning
32%
556/1725
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The radiographs show hindfoot parallelism between the talus and calcaneus which is characteristic of congenital talipes equinovarus, also known as clubfoot. This question emphasizes the importance of the talocalcaneal angle. From a testing perspective, it is important to be able to differentiate clubfoot from congenital vertical talus (CVT) on radiographs. Vertical talus will not show the parallelism between the talus and calcaneus seen with clubfoot and the navicular (which is not ossified in infants) will not be aligned with the talus even on attempts to reduce with plantarflexion. Meary's angle and the talocalcaneal angle are shown for clubfoot and vertical talus in Illustration A and B respectively. Roye, et al. stated that all radiographs of the foot should simulate weight bearing. The two most commonly used measurements are the lateral and AP talocalcaneal angles, which display parallelism. Laaveg et al reviewed the long term treatment of congenital clubfoot and found that functional results were satisfactory in both appearance and function in 88.5% of 104 clubfeet.
4.1
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