doiSerbia

Congenital pes metatarsus varus: Role of arterial abnormalities in feet and treatment duration and outcome in children

Ćirović Dragana (Faculty of Medicine, Belgrade + University Children’s Hospital, Physical Medicine and Rehabilitation Department, Belgrade)
Nikolić Dejan (Faculty of Medicine, Belgrade + University Children’s Hospital, Physical Medicine and Rehabilitation Department, Belgrade)
Knežević Tatjana (University Children’s Hospital, Physical Medicine and Rehabilitation Department, Belgrade)
Bokan-Mirković Vesna (Clinical Centre of Montenegro, Physical Medicine and Rehabilitation Department, Podgorica, Montenegro)
Pavićević Polina (Faculty of Medicine, Belgrade + University Children’s Hospital, Radiology Department, Belgrade)
Radlović Vladimir (University Children’s Hospital, Pediatric Surgery Department, Belgrade)
Petronić Ivana (Faculty of Medicine, Belgrade + University Children’s Hospital, Physical Medicine and Rehabilitation Department, Belgrade)

Introduction/Objective. The aim of this paper was to examine proportion of patients with arterial abnormalities of feet due to age and severity degree of pes metatarsus varus (PMV), and to evaluate the treatment duration and outcome. Methods. The prospective longitudinal study included 240 patients with congenital PMV classified into three age groups: group < 3 months of life (Group 1), group 3–9 months (Group 2), and group 9–12 months (Group 3). Three categories of PMV were analyzed: mild/moderate/severe. Groups with arterial anomalies (Group A) and without (Group B) were analyzed. Clinical outcome was graded as: good/satisfactory/poor. Results. There is statistically significant difference in distribution of children regarding age and severity degree on first visit and presence of feet arterial abnormalities (p < 0.01). For Group A, younger children had longer physical therapy, while for Group B, older children had longer duration of physical therapy. Same trend applies as severity degree of foot deformity increase. In Group A, the most frequent treatment outcome was poor (for Group 1 – 46.7%; Group 2 – 60%; Group 3 – 62%), while in Group B for Group 1 and Group 2 it was frequently good (Group 1 – 90%; Group 2 – 40%), and for Group 3 frequently satisfactory (Group 3 – 53.3%). Conclusion. In children with PMV it might be advisable to perform ultrasound evaluation of arterial structure of feet, and particularly in cases were such deformity is more severe.

Keywords: metatarsus varus, arterial abnormalities, age, severity degree, physical therapy, treatment outcome