Relation between tibia malalignment after tibia nailing and foot pressure pattern.

Area of Science:

• Orthopedic Surgery
• Biomechanics
• Gait Analysis

Background:

• Intramedullary (IM) nailing for tibia fractures can lead to coronal plane malalignment.
• This malalignment may negatively affect foot pressure distribution and gait.
• Understanding this association is crucial for optimizing patient outcomes.

Purpose of the Study:

• To investigate tibia malalignment following IM nailing.
• To assess the association between tibia malalignment and foot pressure distribution using pedobarographic analysis.

Main Methods:

• 42 patients with tibia shaft fractures treated with IM nailing were analyzed.
• Patients were grouped by post-operative coronal plane angulation: valgus (>5°), varus (>5°), and normal (<5°).
• Dynamic pedobarography assessed forefoot/hindfoot peak pressure ratio and pronation-supination index (PSI), comparing affected to unaffected limbs.

Main Results:

• No significant differences in forefoot/hindfoot peak pressure ratio or PSI were found between the three alignment groups (p > 0.5).
• Some patients exhibited higher hindfoot peak pressure on the affected side, potentially indicating a calcaneal gait due to triceps surae injury.
• Tibial coronal plane malalignment below 10° did not significantly alter overall foot position.

Conclusions:

• Post-operative coronal plane alignment of the tibia after IM nailing showed no significant impact on the forefoot/hindfoot peak pressure ratio or PSI.
• The study did not find a correlation between valgus, varus, or normal ankle alignment and altered foot pressure parameters.