- Discussion:
- helps to determine preoperative pathology;
- in infancy, ossification centers of the talus, calcaneus, and cuboid
are present, whereas the navicular does not appear until 3-4 yr;
- Method of Beatson and Pearson; JBJS 1966;
- AP of Foot:
- taken in 30 deg plantarflexion, with the x-ray tube directed
30 deg from the perpendicular;
- lines are drawn longitudinally thru the talus parallel to its
medial border and thru the calcaneus parallel to its lateral
border;
- on AP view, talocalcaneal angle should be between 25-40 deg;
- angle more than 35 deg indicates valgus;
- angle less than 20 deg indicates varus;
- Lateral of Foot:
- taken with the foot in 30 deg of flexion;
- x-ray beam should be perpendicular to both malleoli;
- lines are drawn longitudinally thru the central axis of talus
and parallel to the lower border of the body of the calcaneus;
- parallelism of the calcaneus and talus is key;
- this is recognized as a decr in lateral talocalcaneal angle
which is normally 30-50 deg;
- this does not increase on max dorsiflexion view;
- on lateral view, this angle should be between 35 - 40 deg;
- Forced dorsiflexion lateral:
- will show an angle smaller than nl (35-50 deg);
- w/ club foot, axes of talus & calcaneus becomes more parallel;
- most reliable roentgenographic view is the lateral projection,
usually with the foot in maximum dorsiflexion.
- in clubfoot there is no convergence of talocalcaneal region
(parallel alignment), and the tibiocalcaneal relationship
reveals equinus;
- plantar flexion at the ankle (equinus)
- forefoot and hindfoot inversion (varus);
- Kyte's angles from AP and Lateral views are added together to form
talcalcaneal index;
- in a corrected foot the talocalcaneal index should be greater than 40 degrees;
A Method of Assessing Correction in Club Feet.
Beatson, T. R., and Pearson, J. R.:
J. Bone and Joint Surg., 48-B(1): 40-49, 1966.
Deformity of the calcaneocuboid joint in patients who have talipes equinovarus.
A standardized method for the radiographic evaluation of cludfeet.
GW Simons.
COOR Vol 135. p 107-118. 1978.
