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Assessment of the talar deformity and alignment in congenital clubfoot using three-dimensional MRI after Ponseti method.
J Orthop Sci. 2019 Dec 20 [Online ahead of print]JO

Abstract

BACKGROUND

Ponseti method have been widely accepted as the initial treatment of congenital idiopathic clubfoot because its excellent primary result. On the other hand, relapses after Ponseti method are not uncommon and the cause of relapses have not been fully elucidated. We investigated detailed morphology and alignment of tarsal bones in clubfoot after Ponseti method using three-dimensional MRI analysis.

METHODS

We performed MRI with 10 patients of unilateral clubfoot at three months after Achilles tenotomy. Based on the MRI volume data, we reconstructed three-dimensional bone surface model using the marching cubes method. We evaluated the volume of the talus and navicular bone, medial and planter deviation of the talar head and neck, medial deviation of the navicular bone, and internal rotation angle of the distal tibiofibular joint.

RESULTS

In clubfoot, the volume of talus and navicular bone were significantly smaller compared with the contralateral side. Deviation of the talar head and neck varied from medially to almost the same as that on the contralateral side. The degree of deformity of the talus and alignment of the navicular bone and distal tibiofibular joint showed correlations.

CONCLUSIONS

Patients with the medial deviated talar neck might have the alignment change of navicular bone and distal tibiofibular joint. Deformity of talar neck might to be compensated by talonavicular joint and distal tibiofibular joint through the manipulation of Ponseti method.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Japan.Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Japan. Electronic address: yoshida-kiyoshi@umin.ac.jp.Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Japan.Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Japan.Department of Orthopaedic Surgery, Osaka Women's and Children's Hospital, Japan.Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Japan.Department of Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31866017

Citation

Guda, Haruka, et al. "Assessment of the Talar Deformity and Alignment in Congenital Clubfoot Using Three-dimensional MRI After Ponseti Method." Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association, 2019.
Guda H, Yoshida K, Orito R, et al. Assessment of the talar deformity and alignment in congenital clubfoot using three-dimensional MRI after Ponseti method. J Orthop Sci. 2019.
Guda, H., Yoshida, K., Orito, R., Kobayashi, M., Otsuki, D., Yoshikawa, H., & Sugamoto, K. (2019). Assessment of the talar deformity and alignment in congenital clubfoot using three-dimensional MRI after Ponseti method. Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association. https://doi.org/10.1016/j.jos.2019.11.008
Guda H, et al. Assessment of the Talar Deformity and Alignment in Congenital Clubfoot Using Three-dimensional MRI After Ponseti Method. J Orthop Sci. 2019 Dec 20; PubMed PMID: 31866017.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment of the talar deformity and alignment in congenital clubfoot using three-dimensional MRI after Ponseti method. AU - Guda,Haruka, AU - Yoshida,Kiyoshi, AU - Orito,Ryo, AU - Kobayashi,Masato, AU - Otsuki,Dai, AU - Yoshikawa,Hideki, AU - Sugamoto,Kazuomi, Y1 - 2019/12/20/ PY - 2019/06/03/received PY - 2019/09/20/revised PY - 2019/11/27/accepted PY - 2019/12/24/entrez JF - Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association JO - J Orthop Sci N2 - BACKGROUND: Ponseti method have been widely accepted as the initial treatment of congenital idiopathic clubfoot because its excellent primary result. On the other hand, relapses after Ponseti method are not uncommon and the cause of relapses have not been fully elucidated. We investigated detailed morphology and alignment of tarsal bones in clubfoot after Ponseti method using three-dimensional MRI analysis. METHODS: We performed MRI with 10 patients of unilateral clubfoot at three months after Achilles tenotomy. Based on the MRI volume data, we reconstructed three-dimensional bone surface model using the marching cubes method. We evaluated the volume of the talus and navicular bone, medial and planter deviation of the talar head and neck, medial deviation of the navicular bone, and internal rotation angle of the distal tibiofibular joint. RESULTS: In clubfoot, the volume of talus and navicular bone were significantly smaller compared with the contralateral side. Deviation of the talar head and neck varied from medially to almost the same as that on the contralateral side. The degree of deformity of the talus and alignment of the navicular bone and distal tibiofibular joint showed correlations. CONCLUSIONS: Patients with the medial deviated talar neck might have the alignment change of navicular bone and distal tibiofibular joint. Deformity of talar neck might to be compensated by talonavicular joint and distal tibiofibular joint through the manipulation of Ponseti method. SN - 1436-2023 UR - https://www.unboundmedicine.com/medline/citation/31866017/Assessment_of_the_talar_deformity_and_alignment_in_congenital_clubfoot_using_three-dimensional_MRI_after_Ponseti_method L2 - https://linkinghub.elsevier.com/retrieve/pii/S0949-2658(19)30346-X DB - PRIME DP - Unbound Medicine ER -
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