EP06.16: Leg‐to‐foot and lateral curvature angles: new antenatal markers may predict the postnatal need for surgery in isolated talipes equivinovarus

To correlate antenatal leg-to-foot and lateral foot curvature angles with the need for postnatal surgery in isolated congenital talipes equinovarus (CTEV) fetuses. This is a retrospective study. Fetuses with isolated CTEV detected antenatally and confirmed postnatally (2016-2023)at a South Indian fetal care centre were included. Postnatal outcomes obtained detailing treatment. Scans done by FMF certified operators and data stored in Astraia. Pirani scoring assesses postnatal CTEV severity. We evaluated 2 angles antenatally: leg-to-foot (LFA)indicating lateral talus orientation and lateral curvature (LCA) indicating foot deviation. LFA is angle between fetal leg and foot's medial border. LCA is angle of foot deviation from lateral border. 61 fetuses with isolated CTEV and known outcomes were included. LFA ranged from 89 to 134° and LCA ranged from 0 to 39.7°. 21 fetuses had LFA between 89-100°- 42.8% (9) needed cast, 33.3% (7) needed surgery, 9.7% (2) needed physiotherapy and 14.2% (3) needed no treatment. 21 fetuses had LFA measuring 100.1-110°- 57.1% (12) needed cast, 28.5% (6) needed surgery, 9.6% (2) needed physiotherapy and 4.8% (1) needed no treatment. 10 fetuses had LFA between 110.1-120 degrees–50% (5) needed cast, 30% (3) needed surgery, 10% (1) needed physiotherapy and 10% (1) needed no treatment. 9 fetuses had LFA between 120.1 to 134°–33.3% (3) needed cast, 22.2% (2) needed surgery, 33.3% (3) needed physiotherapy and 11.1% (1) needed no treatment. 26 fetuses had LCA between 0-10°-46.1% (12) needed cast, 7.7% (2) needed surgery, 30.7% (8) needed physiotherapy and 15.4% (4) did not need treatment. 20 fetuses had LCA between 10.1-20°-60% (12/20) needed cast, 30% (6) needed surgery and 10% (2) needed physiotherapy. 15 fetuses had LCA measuring 20.1°–33.3% (5) needed cast and 66.6% (9) needed surgery. Study suggests 2 angles to predict need for postnatal CTEV surgery. LCA >20° correlated with 66.6% surgery and LFA lacked correlation. Angles are easily measurable. Hence, we propose larger studies to assess utility in prediction of surgery and aiding parental counselling.