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Patients with Crowe Type‐IV congenital dislocation of the hip (CDH) show significant clinical improvement after total hip arthroplasty (THA) because this surgery greatly reduces pain. Concomitant leg‐length equalization in unilateral patients — a controversial procedure — theoretically should significantly improve these patients' ability to walk efficiently and comfortably. To understand the impact of leg‐length equalization on these patients, we compared their gait parameters with those of untreated patients without pain but with leg‐length discrepancy. Using a motion analysis system, three force platforms and computer calculation, the gait parameters during level walking of 22 women with unilateral Crowe Type‐IV CDH were studied at an average of 58 months (27–98 months) following a successful cementless THA. The socket was placed in the best bone stock, which was close to the level of the true acetabulum. The leg‐length discrepancy was equalized to within 2 cm in all patients. The Harris hip score averaged 94.8 (range, 88–100) at the time of the study. Nine women with untreated unilateral Crowe Type‐IV CDH without major pain but with an average leg‐length discrepancy of 4.7 cm (range, 2.5–6 cm) were also studied for comparison. The treated subjects (Group 1; THA and leg‐length equalization) walked faster and had gait parameters with better bilateral symmetry than the untreated subjects (Group 2). We concluded that leg‐length equalization in addition to THA in patients with unilateral Crowe Type‐IV CDH significantly improves gait symmetry and efficiency. © 2001 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved.

ObjectivesThe purpose of this study was to examine the correlation between the foot arch volume measured from static positions and the plantar pressure distribution during walking.MethodsA total of 27 children, two to six years of age, were included in this study. Measurements of static foot posture were obtained, including navicular height and foot arch volume in sitting and standing positions. Plantar pressure, force and contact areas under ten different regions of the foot were obtained during walking.ResultsThe foot arch index was correlated (r = 0.32) with the pressure difference under the midfoot during the foot flat phase. The navicular heights and foot arch volumes in sitting and standing positions were correlated with the mean forces and pressures under the first (r = −0.296∼−0.355) and second metatarsals (r = −0.335∼−0.504) and midfoot (r = −0.331∼−0.496) during the stance phase of walking. The contact areas under the foot were correlated with the foot arch parameters, except for the area under the midfoot.ConclusionsThe foot arch index measured in a static position could be a functional index to predict the dynamic foot functions when walking. The foot arch is a factor which will influence the pressure distribution under the foot. Children with a lower foot arch demonstrated higher mean pressure and force under the medial forefoot and midfoot, and lower contact areas under the foot, except for the midfoot region. Therefore, children with flatfoot may shift their body weight to a more medial foot position when walking, and could be at a higher risk of soft tissue injury in this area.

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