Plantar Pressures After Nonoperative Treatment for Clubfoot: Intermediate Follow-up at Age 5 Years

Abstract

Level II-therapeutic.

Pedobarographic Analysis following Ponseti Treatment for Unilateral Neglected Congenital Clubfoot

“…Some studies used the plantar pressure measurement systems to evaluate the outcome of patients presenting with clubfoot at an early age following nonoperative and surgical management. They found that the clubfeet treated using Ponseti method had higher PP and PTI in the midfoot 26 , 28 – 30 and lateral forefoot 26 , 30 , whereas the PP and PTI were substantially lower in the medial forefoot 26 , 28 – 30 and hindfoot 26 , 29 , 30 , compared with the healthy controls. Similarly, in the present study, the PP and PTI were higher in the M5 and MF zones and lower in the affected feet in the M1, M2, and MH zones compared with those in the unaffected side and control group.…”

“…These results indicated a load transfer from the medial forefoot and hindfoot to the lateral forefoot and midfoot 24 , 28 . The deviations could be attributed to the more medially progression angle 26 , 42 , limitation in dorsiflexion of the affected foot 24 , 32 , lower ankle plantar flexion moment due to calf weakness 1 , 43 , midfoot break appearance, and more lateral position of the foot in relation to the ground 26 . These changes might be a sign of under correction or recurrence 29 and are difficult to detect by clinical examination.…”

“…However, Jean et al . were concerned that the high loading on the lateral side of the foot might eventually lead to skin problems, pain 26 , and lower extremity overuse injuries 44 . A longer follow-up is needed to monitor and assess the effect of the high loading on the lateral part of the affected clubfeet.…”

“…1 ). After each measurement, a visual checking and manual correction were made by the same experienced observer (C.X) to assure that the anatomical structures fitted with the masked zones 26 , 38 .

Figure 1 Schematic diagram for the 10 subdivided zones of the foot.

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Perspectives on gait and motion analysis in the management of youth with arthrogryposis multiplex congenita

“…clubfoot). This complex foot deformity affects pressure distribution under the foot and despite treatment being efficient in correcting the deformity, some atypical pressure distribution can remain (Jeans, Erdman, & Karol, ). This analysis is already use with foot deformity present in other pediatric disease like with Charcot–Marie–Tooth disease (Erickson et al, ).…”