Radiographic assessment of congenital talipes equinovarus: strapping versus forced dorsiflexion.

EHK Yeung, YH Li, ON Ng, W Chow
The Duchess of Kent Children’s Hospital, Sandy Bay, Hong Kong

PURPOSE. To compare 2 radiographic assessment methods for congenital talipes equinovarus: strapping the ankle with tapes versus dorsiflexion with a wooden block.

METHODS. Anteroposterior and lateral radiographs were taken with the ankle strapped by tapes or dorsiflexed by a wooden block. Talocalcaneal and tibiocalcaneal angles were measured and analysed.

RESULTS. 20 radiographic assessments were performed on 14 patients. From the anteroposterior view, the mean talocalcaneal angle with strapping was 19.4 degrees (range, 0-34.0 degrees; standard deviation [SD], 11.2 degrees). From the lateral view, the mean talocalcaneal angle with strapping was 22.0 degrees (range, 8.0-38.8 degrees; SD, 8.9 degrees) and with forced dorsiflexion was 21.0 degrees (range, 0-52.7 degrees; SD, 11.3 degrees), with a mean absolute difference of 9.4 degrees between the 2 groups. The mean tibiocalcaneal angle with strapping was 77.9 degrees (range, 43.2-120.0 degrees; SD, 18.8 degrees) and with forced dorsiflexion was 78.2 degrees (range, 29.5-134.0 degrees; SD, 24.7 degrees), with a mean absolute difference of 15.7 degrees between the 2 groups. The difference between the tibiocalcaneal measurements in the 2 groups was statistically significant (p=0.026).

CONCLUSION. Similar results were obtained for talocalcaneal and tibiocalcaneal angles measured with strapping and forced dorsiflexion. However, the strapping method provides better stabilisation while radiographs are taken.