Abstract
The use of antenatal abdominal ultrasound (AAU) in the diagnosis of clubfoot is established. The accuracy of the investigation is unclear, leaving difficulties for the clinician involved in counselling parents.
This study was conducted to investigate the accuracy of AAU in the diagnosis of clubfoot. We assessed the AAU findings of mothers of 20 children with varying degrees of clubfoot deformity between 1993 to 1998. There were 12 males and 8 females; 30 feet were affected - 6 were left, 8 right sided and 8 were bilateral. There were two sets of twins, each with bilateral deformity. The mean foetal age at diagnosis was 23.4 weeks ( range 18–35 weeks).
Three patients had oligohydramnios and two had polyhydramnios. One patient had an amniocentesis that was normal. Karyotyping was not performed. There were no false positive or false negative results.
Our results show 100% concurrence between the scan results and the clinical findings at birth. Three clubfeet were reported as being positional; their clinical diagnoses revealed a mild deformity that needed no treatment other than reassurance and advice. Twenty one feet were treated with physical therapy, manipulation and serial castings. Six feet required surgery.
AAU in the second trimester of pregnancy is a reliable method of diagnosing clubfoot, and the parents can be counselled with confidence regarding management. As AAU is currently offered to almost all pregnant women, it can be expected that more cases of clubfeet will be diagnosed in the antenatal period. An orthopaedic surgeon must be prepared to counsel parents even before a clinical examination is possible.
The abstracts were prepared by Mr Simon Donell. Correspondence should be addressed to him at the Department of Orthopaedics, Norfolk & Norwich Hospital, Level 4, Centre Block, Colney Lane, Norwich NR4 7UY, United Kingdom.
