Clinical or radiologic measurements and 3-D gait analysis in children with pes planus

Static measurement in clinical and radiologic evaluation is often used in assessment of pes planus, but it is important to know whether pes planus leads to abnormal gait pattern. The purpose of the present study was to assess the clinical and radiologic findings of children with pes planus and the relationship between clinical, radiologic findings and parameters obtained in 3-D gait analysis.

Thirteen children with pes planus were selected. Physical measurements included femoral anteversion, internal and external rotation, thigh-foot angle (TFA), and resting calcaneal stance position (RCSP). Radiologic measurements included talo-calcaneal angle (TCA), talometatarsal angle (TMA), calcaneal pitch, and forefoot adduction on simple X-ray, and femoral anteversion, tibial torsion and rotation on computed tomography (CT). 3-D gait analysis was also performed and kinetic and kinematic data were obtained in sagittal, frontal, and transverse plane. The correlation between clinical, radiologic, and gait analysis data was investigated.

RCSP was found to be significantly correlated with TMA. TMA was also correlated with TCA. TCA on simple X-ray was correlated with maximal internal and external rotation angle of the knee joint on gait analysis.

TMA was the factor most related to degree of calcaneal valgus measured on physical exam. Larger TCA contributed to decreased maximal external rotation and increased maximal internal rotation in gait cycle. Clinical or radiological methods, however, had very limited ability to predict gait deviance of pes planus.