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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 7, 990-993.
doi: 10.1302/0301-620X.87B7.16076  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Prenatal ultrasound diagnosis of club foot

OUTCOME AND RECOMMENDATIONS FOR COUNSELLING AND FOLLOW-UP

E. Bar-On, MD, Director of Pediatric Orthopedics1; R. Mashiach, MD, Gynaecologist2; O. Inbar, MD, Gynaecologist3; D. Weigl, MD, Orthopedic Surgeon1; K. Katz, MD, Orthopedic Surgeon (Professor)1; and I. Meizner, MD, Gynaecologist (Professor)2

1 Pediatric Orthopedic Unit Schneider Children’s Medical Center, 14 Kaplan Street, Petah Tikva 49202, Israel.
2 Ultrasound Unit, Department of Obstetrics and Gynaecology Rabin Medical Center, Beilinson Campus, Petah Tikva 49100, Israel.
3 Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.

Correspondence should be sent to Dr E. Bar-On; e-mail: elbar{at}barak-online.net

Club foot was diagnosed by ultrasonography in 91 feet (52 fetuses) at a mean gestational age of 22.1 weeks (14 to 35.6). Outcome was obtained by chart review in 26 women or telephone interview in 26. Feet were classified as normal, positional deformity, isolated club foot or complex club foot.

At initial diagnosis, 69 feet (40 fetuses) were classified as isolated club foot and 22 feet (12 fetuses) as complex club foot. The diagnosis was changed after follow-up ultrasound scan in 13 fetuses (25%), and the final ultrasound diagnosis was normal in one fetus, isolated club foot in 31 fetuses, and complex club foot in 20 fetuses.

At birth, club foot was found in 79 feet in 43 infants for a positive predictive value of 83%. Accuracy of the specific diagnosis of isolated club foot or complex club foot was lower; 63% at the initial ultrasound scan and 73% at the final scan. The difference in diagnostic accuracy between isolated and complex club foot was not statistically significant. In no case was postnatal complex club foot undiagnosed on fetal ultrasound and all inaccuracies were overdiagnoses. Karyotyping was performed in 25 cases. Abnormalities were noted in three fetuses, all with complex club foot and with additional findings on ultrasound.




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[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General