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Gait and pedobarographic patterns of surgically treated clubfeet
1Department of Orthopaedic Surgery, National University Hospital, Singapore.
Insights
Surgically corrected clubfeet show subtle gait abnormalities in children, including internal foot rotation and altered pressure distribution. Gait analysis and pedobarography offer objective assessments for persistent deformities.
Area of Science:
- Orthopedics
- Biomechanics
- Pediatrics
Background:
- Clubfoot is a common congenital foot deformity.
- Surgical correction is the primary treatment for clubfoot.
- Objective assessment of surgical outcomes is crucial.
Purpose of the Study:
- To evaluate gait and foot pressure in surgically corrected clubfeet using gait analysis and pedobarography.
- To identify subtle abnormalities and persistent deformities in corrected clubfeet.
- To compare gait parameters in children with corrected clubfeet to those of normal children.
Main Methods:
- Gait analysis and pedobarography were performed on 58 surgically corrected clubfeet in 40 children.
- Patients' ages at surgery and at analysis were recorded.
- Gait parameters (cadence, velocity, stance duration, step length, ground reaction force) and plantar pressures were measured.
Main Results:
- Most measured gait parameters were not significantly different from normal children.
- Differences observed included lack of age-related increase in single-limb stance duration for bilateral clubfeet, absence of increased ankle plantarflexion, persistent internal foot rotation (toe-in gait), age-related differences in ground reaction forces, and increased mid/forefoot pressures.
Conclusions:
- Gait analysis and pedobarography can detect subtle abnormalities in surgically corrected clubfeet.
- These methods provide objective assessments of persistent deformities.
- Findings highlight specific gait deviations and pressure alterations in treated clubfeet.
Abstract:
Gait analysis and pedobarography were done on 58 surgically corrected clubfeet in 40 children. The average age of patients at the time of surgery was 6.7 months. The average age of the children at the time of the gait analysis was 6.1 years. Twenty-two children (32 feet) were 5 years old and younger. Eighteen children (26 feet) were older than 5 years old. Cadence, velocity, duration of single-limb stance, step length, and ground reaction force measurements were not significantly different from normal children. Differences noted in clubfeet were: 1) duration of single-limb stance among bilateral clubfeet did not increase with age; 2) increased ankle plantarflexion between opposite foot-strike and toe-off was not present; 3) the feet were internally rotated throughout (toe-in gait); 4) anterior and lateral ground reaction force measurements revealed differing trends with age; and 5) mid- and forefoot pressures increased in the surgically treated group. Gait analysis and pedobarography could detect more subtle abnormalities in corrected clubfeet and provide more objective assessments of persistent deformities.