Radiographic Evaluation of Foot Deformities in Children with Cerebral Palsy

ABSTRACT

OBJECTIVE: To evaluate whether 7 radiographic angles make a useful method for analysing foot deformities in children with cerebral palsy, and to assess with changes in angles after 2 years with orthoses or operations. METHOD: The talocalcaneal, talus-first metatarsal, and calcaneus-fifth metatarsal angles on the AP radiographs and the talocalcaneal, tibiotalar, talus-first metatarsal, and talohorizontal angles on the lateral radiographs were measured in 183 cerebral palsied. Seven angles were analyzed according to the clinical types, spasticity, ambulation, and age. One hundred three feet were followed up for 2 years with application of orthoses or operations. RESULTS: The frequencies of higher range in AP talocalcaneal angle were 24.4% in spastic diplegia. The increased frequencies for abnormal range increased as the grade of spasticity. Non-ambulator group had many frequencies of lower range in AP talocalcaneal angle. The age of 8~9 years showed high peak in the frequency of abnormal range. After 2 years, the frequencies of normal range were increased in groups with orthoses or operations. CONCLUSION: The radiographic angles were a useful method for observing feet of the children with cerebral palsy. If the appropriate interventions for feet were applied, the normal frequencies of radiographic angles were increased after 2 years.