3-DIMENSIONAL ANALYSIS OF CLUBFOOT DEFORMITY BY COMPUTED-TOMOGRAPHY

The bony pathoanatomy of clubfoot has been assessed by a three dimensi onal reconstruction of transverse CT images obtained from 27 feet in c hildren aged 3-10 years. Principal axes of the bones were determined t o quantitate interosseous deformity, while visual inspection of the re constructed images demonstated intraosseous deformity. ''Medial spin'' and midfoot adduction were analyzed on the AP view of the foot (''top '' view), while hindfoot pronosupination was analyzed on the AP view o f the ankle (posterior view). This technique allows visualization of d eformities which normally cannot be analyzed on plain radiographs, and also shows that a variety of interosseous relationships make up the c linical entity known as clubfoot. Abnormal talar pronation (''intorsio n'') was an unexpected finding of this three dimensional analysis.