Pedobarography and ankle-foot kinematics in children with symptomatic flexible flatfoot after medialising calcaneal osteotomy and controls: a comparative study.

IF 2 3区 医学 Q2 ORTHOPEDICS International Orthopaedics Pub Date : 2024-11-01 Epub Date: 2024-09-05 DOI:10.1007/s00264-024-06290-6
Phatcharapa Osateerakun, Panapol Varakornpipat, Kittigon Seehaboot, Noppachart Limpaphayom
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Abstract

Purpose: Flexible flatfoot (FF) can interrupt children's activity through uneven pressure distribution to the medial column of the foot and may require surgery. Medialising calcaneal osteotomy (MCO) helps restore the foot‒tripod complex. The objective was to compare pedobarography and ankle‒foot kinematics in children with symptomatic FF after MCO to those in controls.

Methods: Gait analysis was performed on 21 children with FF (37 feet, age 13.7 ± 4.9 years) 4.5 ± 3.4 years after MCO and on 21 controls (42 feet, age 12.1 ± 1.1 years). Ankle‒foot kinematics and pedobarography parameters (maximum pressure, impulse, contact area, and percentage of contact time in the stance phase) of ten anatomic foot regions from an average of five gait trials were compared. The functional outcome was determined by the AOFAS-AHFS score in the FF group.

Results: The average AOFAS-AHFS score was 96. The FF group had a larger contact area and expressed more force on the medial column of the foot. The maximum pressure, impulse, contact area, and percentage of contact time in the stance phase in the midfoot region for the FF and control groups were 0.66 ± 0.5 vs. 0.24 ± 0.4 N/cm2 (p = 0.005), 0.12 ± 0.1 vs. 0.03 ± 0.1 Ns/cm2 (p = 0.02), 47.1 ± 13.4 vs. 30.1 ± 7.1 cm2 (p < 0.001), and 53.7 ± 17.4 vs. 68.2 ± 15.7% (p = 0.007), respectively. The kinematics of the FF exhibited a greater range of abduction and eversion during the mid- and terminal-stance phases of the gait cycle.

Conclusions: The MCO procedure did not normalise the pressure on the midfoot in FF to the level of that in the controls, and the deformity persisted in the forefoot.

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小腿骨内侧截骨术后有症状的柔性扁平足患儿与对照组的足底照相和踝足运动学:一项比较研究。
目的:灵活型扁平足(FF)会因足内侧柱压力分布不均而影响儿童的活动,可能需要手术治疗。小腿内侧截骨术(MCO)有助于恢复足三足复合体。本研究的目的是比较 MCO 术后有 FF 症状的儿童与对照组的足动图和踝足运动学:对 21 名 MCO 4.5 ± 3.4 年后患有 FF 的儿童(37 足,年龄 13.7 ± 4.9 岁)和 21 名对照组儿童(42 足,年龄 12.1 ± 1.1 岁)进行了步态分析。比较了平均五次步态试验中十个足部解剖区域的踝足运动学和足底造影参数(最大压力、冲力、接触面积和站立阶段接触时间百分比)。功能结果由 FF 组的 AOFAS-AHFS 评分决定:结果:AOFAS-AHFS平均分为96分。FF 组的接触面积更大,对足部内侧柱的作用力更大。FF 组和对照组在站立阶段足中部区域的最大压力、冲量、接触面积和接触时间百分比分别为 0.66 ± 0.5 vs. 0.24 ± 0.4 N/cm2(p = 0.005)、0.12 ± 0.1 vs. 0.03 ± 0.1 Ns/cm2(p = 0.02)、47.1 ± 13.4 vs. 30.1 ± 7.1 cm2(p 结论MCO 手术并没有将 FF 中足的压力恢复到对照组的正常水平,前足的畸形仍然存在。
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来源期刊
International Orthopaedics
International Orthopaedics 医学-整形外科
CiteScore
5.50
自引率
7.40%
发文量
360
审稿时长
1 months
期刊介绍: International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.
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