Significance of radiographic angle measurements in evaluation of congenital clubfoot.

Numerous formal, positional and angular foot skeleton deviations have been described in radiographic evaluation of congenital clubfoot. To clear up the correlation between clinical and radiological findings, a retrospective study involving 62 cases of congenital clubfoot in 38 patients was carried out, including follow-up observation for 7 years after soft-tissue surgery. Only clubfeet with grade II Harrold and Walker classifications according to the initial findings were included. Clinical follow-up examinations followed the Functional Rating System (FRS) of Laaveg and Ponseti. The postoperative talocalcaneal (TC) angle, measured on a lateral image, averaged 23 degrees as opposed to 32 degrees in healthy feet, i.e. much smaller, although this very significant angle dimension showed only minimum differences between the evaluation groups "very good" to "poor". The TC angle anteroposterior (AP), talonavicular angle (AP and lateral) as well as the calcaneometatarsal V angle revealed considerable deviations, although a correlation of clinical severity grading with the measured angular dimensions was not possible due to measurement imprecision and the range of values occurring within the different severity groups.