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Validity of the Anteroposterior Talocalcaneal Angle to Assess Congenital Clubfoot Correction

E. Ippolito1, L. Fraracci2, P. Farsetti1 and F. De Maio1

1 Department of Orthopaedic Surgery, University of Rome "Tor Vergata," Via Montpellier 1, Roma 00133, Italy.
2 Department of Radiology, IRCCS Santa Lucia Institute, Via Ardeatina 306, Roma 00179, Italy.



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Fig. 1A. 25-year-old man with unilateral right clubfoot. Standing anteroposterior radiograph of both feet shows anteroposterior talocalcaneal angle measured 25° on left and 15° on right.

 


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Fig. 1B. 25-year-old man with unilateral right clubfoot. Three-dimensional CT scan reconstruction in cephalad view of feet at level of talar trochlea shows declination angle of neck of talus (dashed lines) measured 16° on left and 42° on right; increased medial angulation of neck of talus caused false radiographic projection instead of real anatomic relationship of talus and calcaneus. In fact, anteroposterior talocalcaneal angle (solid lines) measured 0° on right and 25° on left.

 


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Fig. 1C. 25-year-old man with unilateral right clubfoot. Three-dimensional CT scan reconstruction in coronal plane shows sustentaculum tali (arrows). Medial talar offset is absent in right clubfoot. Anatomic axes of talus and calcaneus () are coincident in right clubfoot and divergent in left normal foot.

 


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Fig. 1D. 25-year-old man with unilateral right clubfoot. Three-dimensional CT scan reconstruction in cephalad view obtained at level of sinus tarsi (ST) shows long axis of posterior facet of subtalar joint (PF) and longitudinal axis of calcaneus form angle of 42° on left normal foot and angle of 90° on right clubfoot.

 

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