Pedobarographic Analysis following Ponseti Treatment for Unilateral Neglected Congenital Clubfoot

Chao Xu, Jie Wei, Ya-Bo Yan, Lei Shang, Xiao-Jiang Yang, Lu-Yu Huang, Wei Lei, Chao Xu, Jie Wei, Ya-Bo Yan, Lei Shang, Xiao-Jiang Yang, Lu-Yu Huang, Wei Lei

Abstract

Recent trends have led to an interest in Ponseti treatment for correcting neglected congenital clubfoot. Although good clinical and functional outcomes have been reported, the plantar pressure distribution after the treatment of neglected clubfoot has not been explored yet. The present study aimed to investigate whether plantar pressures normalized following Ponseti treatment in patients with neglected congenital clubfoot. Pedobarographic, clinical, and functional examinations were performed in 22 children (aged, 91.0 ± 40.3 months) with unilateral neglected congenital clubfeet, treated using Ponseti method at 27.8 ± 12.1 months of age. Plantar pressure parameters were recorded using a Footscan pressure plate. The contact time, contact area, peak pressure, and pressure-time integral were determined. The data of the affected feet were compared with those of the unaffected feet and healthy controls. Although clinical and functional examinations showed satisfactory results according to the Dimeglio and Pirani scores, considerable differences in plantar pressure parameters were identified among the affected feet, unaffected feet, and healthy controls. Internal foot progression angle and a load transfer from the medial forefoot and hindfoot to the lateral forefoot and midfoot were observed in the affected feet. Future studies should attempt to investigate the factors accounting for plantar pressure deviations and the possible effect of these deviations on the lower limb musculoskeletal development of children.

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Schematic diagram for the 10 subdivided zones of the foot. The subdivided zones were (T1) hallux, (T2–5) toes 2–5, (M1) first metatarsal, (M2) second metatarsal, (M3) third metatarsal, (M4) fourth metatarsal, (M5) fifth metatarsal, (MF) midfoot, (MH) medial heel, and (LH) lateral heel.
Figure 2
Figure 2
Examples of the foot progression angle. The purple line is located between the medial and lateral parts of the heel and between the second and third metatarsal heads. The white dotted line is the gait direction. (a) Exo rotation of the left foot (θ = 13.36°). (b) Endo rotation of the right foot (θ = −10.53°).
Figure 3
Figure 3
The curves of the peak pressure (PP) for the 10 masked zones of a representative subject. (a) Curves of the PP in the affected foot. (b) Curves of the PP in the unaffected foot. (c) Curves of the PP in the control foot. The subdivided zones were (Toe 1) hallux, (Toe 2–5) toes 2–5, (Meta 1) first metatarsal, (Meta 2) second metatarsal, (Meta 3) third metatarsal, (Meta 4) fourth metatarsal, (Meta 5) fifth metatarsal, (Midfoot) midfoot, (Heal medial) medial heel, and (Heel) lateral heel. 1 N/cm2 = 10 kPa.

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Source: PubMed

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