Radiographic Angle Changes After Planovalgus Foot Surgery in Pediatric CP Patients
Overview
This retrospective study analyzed radiographic angular changes in pediatric cerebral palsy patients undergoing Mosca’s calcaneal lengthening for planovalgus foot deformity. Significant improvements in key foot alignment angles were observed postoperatively, with sustained correction at two years. These findings provide objective evidence supporting the surgical approach and aid clinical decision-making.
Background
Cerebral palsy is a leading cause of motor disability in children, often resulting in orthopedic deformities such as planovalgus foot, which affects 25–30% of patients. This deformity involves complex anatomical changes including talar plantar flexion, calcaneal external rotation, and navicular displacement, leading to medial arch collapse and functional impairment. Weight-bearing radiographs with angular measurements are critical for diagnosis, treatment planning, and postoperative evaluation. However, limited data exist on how these radiographic angles change following surgical correction in this population.
Data Highlights
Radiographic Angle
Preoperative Mean (°)
Immediate Postoperative Mean (°)
6 Months Postoperative Mean (°)
1 Year Postoperative Mean (°)
2 Years Postoperative Mean (°)
AP Talocalcaneal Angle (Kite’s Angle)
45
30
28
27
26
AP Talo–1st MT Angle
20
10
9
8
7
Talonavicular Coverage Angle
40
25
23
22
21
Moreau–Costa–Bartani Angle
160
140
138
135
134
Meary’s Angle (Lateral Talo–1st MT)
15
5
4
3
3
Calcaneal Inclination Angle
10
20
22
23
24
Key Findings
Significant reduction in AP talocalcaneal angle from preoperative to postoperative periods, indicating improved hindfoot alignment.
Marked decrease in AP talar–first metatarsal angle, reflecting correction of forefoot abduction.
Improvement in talonavicular coverage angle, demonstrating enhanced midfoot congruency post-surgery.
Increase in calcaneal inclination angle, suggesting restoration of the medial longitudinal arch height.
Consistent improvements maintained through two years postoperatively, supporting durability of surgical correction.
Standardized radiographic protocol enabled reliable longitudinal assessment of angular parameters.
Clinical Implications
These results affirm that Mosca’s calcaneal lengthening effectively corrects key radiographic deformities in spastic planovalgus feet in children with cerebral palsy. Regular postoperative radiographic monitoring using standardized angular measurements is essential to evaluate surgical success and guide rehabilitation. Understanding these angular changes can assist orthopedic surgeons in optimizing treatment strategies and improving functional outcomes.
Conclusion
Surgical correction of planovalgus foot deformity in pediatric cerebral palsy patients results in significant and sustained improvements in radiographic angular parameters. This study provides valuable quantitative data to support clinical decision-making and postoperative assessment in this population.
References
Shriners Children’s Mexico Research and Ethics Committee 2023 -- Study on Radiographic Angles in Planovalgus Correction
Literature References 1-7, 29 -- Background on Cerebral Palsy and Planovalgus Foot Deformity
by Ana Laura Arenas-Díaz, Agustín Barajas-Monterrey, Silvestre Fuentes-Figueroa, Erika Alejandrina Barrón-Torres, Clemente Hernández-Gómez, Carlos A. Guzmán-Martín
