Abstrait: L'équin, le varus, le creux et l'adduction sont des signes typiques du varus équin congénital du pied bot (CTEV). L'adduction de l'avant-pied reste une difficulté liée à l'utilisation des méthodes correctives précédentes. Cette étude vise à développer une méthode corrective pour réduire la sévérité de l'adduction de l'avant-pied des enfants CTEV avec des déformations modérées pendant leur âge de marche. La méthode mise au point a été comparée à 2 autres méthodes correctives courantes pour évaluer son efficacité.

A Dennis Brown (DB) splint, DB splint with orthopedic shoes (OS), and forefoot abduct shoes (FAS) with OS were, respectively, applied to 15, 20, and 18 CTEV children with moderate deformities who were scored at their first visit according to the Dime´glio classification. The mean follow-up was 44 months and the orthoses were changed as the children grew. A 3D scanner and a high-resolution pedobarograph were used to record morphological characteristics and plantar pressure distribution. One-way MAVONA analysis was used to compare the bimalleolar angle, bean–shape ratio, and pressure ratios in each study group.

There were significant differences in the FASþOS group compared to the DB and DBþOS groups (P<0.05) for most measurements. The most salient differences were as follows: the FASþOS group had a significantly greater bimalleolar angle (P<0.05) and lower bean–shape ratio (P<0.01) than the other groups; the DBþOS and FASþOS groups had higher heel/forefoot and heel/LMF ratios (P<0.01 and P<0.001) than the DB group.

FAS are critical for correcting improper forefoot adduction and OS are important for the correction of equinus and varus in moderately afflicted CTEV children. This study suggests that the use of FASþOS may improve treatment outcomes for moderate CTEV children who do not show signs of serious torsional deformity.