Perfusion is not Measurably Decreased in Idiopathic Clubfoot

Dan Atar Wallace B. Lehman Alice Chu Lynn Forrester Rachel Shakked Norman Otsuka
Pediatric Orthopedic Surgery, NYU/Langone Hospital for Joint Diseases Medical Center, New York, USA

Purpose: Abnormal vasculature has been observed in as much as 85% of children with clubfoot. The purpose of this study was to compare foot perfusion between clubfeet and unaffected feet.

Method: A Masimo Radical 7 Pulse Oximeter (Masimo Corporation, Irvine, CA) was used to measure the foot perfusion index (PI) of children five years of age and younger. Patients with clubfoot undergoing non-operative treatment, and control patients undergoing treatment for orthopaedic concerns not involving the foot, were tested. Exclusion criteria for patients with clubfoot were previous clubfoot surgery and non-idiopathic etiology. The PI of the affected clubfeet was compared to the PI of the unaffected feet of the controls.

Results: Sixty-six patients were enrolled, 34 with clubfoot (16 bilateral and 18 unilateral), and 32 controls. No significant difference in PI was found between the affected feet and the unaffected feet (3.1 vs 2.5; p=0.200).

Conclusion: This analysis showed no difference in PI between clubfeet and unaffected feet of controls.

Significance: Although abnormal vasculature in clubfoot has been reported, the perfusion to a non-operative treated clubfoot is similar to an unaffected foot.