Tibial torsion; does it differ in children with congenital talipes equinovarus (ctev) compared to normal ones?

Abstract

Background: Congenital talipes equinovarus (CTEV) or clubfoot is one of the commonest congenital orthopaedic conditions requiring intensive treatment. A typical clubfoot consists of a deformed foot in equinus ,varus, adduction. In some cases a cavus component is also there. Tibial torsion is the angle between the transverse axes of the proximal and distal tibial articular surfaces. Controversy exists concerning the presence or absence of excessive medial or internal tibial torsion in CTEV. Materials & Methods: A cross sectional study was done of thirty consenting patients with CTEV and thirty children with injuries not involving the tibia or fibula selected by convenience sampling attending the orthopaedic clinic of a tertiary care hospital of Western Maharashtra . We measured the angular difference between the proximal and distal posterior tibial planes as defined by ultrasound scans thus minimising the error introduced by the posterior shifting of lower end fibula in the fibular notch after manipulative correction. The data was entered in excel and appropriate statistic test was applied. Results: The mean external torsion of the tibia in children with CTEV was 18 degrees (standard deviation 2.7), which was significantly less than the mean external torsion of tibia in normal children (38.13 degrees; standard deviation 9.194) (p<0.05). Conclusions: The children with CTEV have a relative tibial intorsion, as compared to normal children.