gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie, 75. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 97. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 52. Tagung des Berufsverbandes der Fachärzte für Orthopädie und Unfallchirurgie

25. - 28.10.2011, Berlin

Prospectiv pedobarograpgic study in surgical valgus foot correction in children with diplegic cerebral palsy

Meeting Abstract

Suche in Medline nach

  • J. Matussek - Orthopädische Klinik, Kinderorthopädie, Universität Regensburg, Bad Abbach-Regensburg, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie. 75. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 97. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 52. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 25.-28.10.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocWI40-1665

DOI: 10.3205/11dkou228, URN: urn:nbn:de:0183-11dkou2282

Veröffentlicht: 18. Oktober 2011

© 2011 Matussek.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Questionnaire: Readily available pedobarographic insoles to measure rapid pressure changes during gait possibly give sufficient indirect kinematic data to characterize relative pressure changes during the foot's roll-over process. This enables the clinician to prospectively compare a baseline of dynamic pedobarographic and indirect kinematic data of pre- and postoperative gait in valgus feet with data acquired from healthy subjects.

Methods: 19 children and adolescents (GMFCS I-III) between 9 and 12 yrs.(f: 8/m:11) with severe flexible valgus foot deformities due to CP (Tetraplegic n: 2; Diplegic n: 14; Hemiplegic n:3) who underwent bony subtalar fusion and calf tendon lengthening procedures were studied pre and postoperatively with and without orthotics. Outcome measurements were done between 12 and 18 months postsurgery. These children underwent video and pedobarographic gait analysis with a wireless 64-pressure-sensor 60-Hz system (capacitive pressure measurement system Medilogic®). All had standardized foot x-ray. A control group of 20 clinically healthy feet rendered so-called normal pressure distribution data. Gait parameters included speed, stride length, effective foot length, CoP line (centre of pressure), width of gait line as well as hind-, mid- and fore- foot pronation indexes as a measure of indirect foot kinematics (inversion/eversion).

Results and conclusions: CoP line, effective foot length and foot pronation indexes significantly improved in n:14 (n: 3 hemiplegic, n: 11 diplegic patients) already without bracing, whereas an additional AFO adjusted measurements close to those of the control group. In n:5 children, AFO bracing was compulsory to stabilize gait, but was done more comfortably postsurgically than before. Data from the control group surprised with a high degree of variation and although clinically normal, foot pressure patterns from highly inverted to plano-valgus were observed.

Discussion: Insights into the indirect kinematics of valgus foot deformities are easily available with dynamic pedobarography; functional evaluation with and without AFO bracing is possible giving valuable information into whether longterm postsurgical bracing is necessary.