Analysis of Dynamic Plantar Pressure and Influence of Clinical-Functional Measures on Their Performance in Subjects with Bimalleolar Ankle Fracture at 6 and 12 Months Post-Surgery

Abstract

Recovery after ankle fracture surgery can be slow and even present functional deficits in the long term, so it is essential to monitor the rehabilitation process objectively and detect which parameters are recovered earlier or later. The aim of this study was 1) to evaluate dynamic plantar pressure and functional status in patients with bimalleolar ankle fracture 6 and 12 months after surgery, and 2) to study their degree of correlation with previously collected clinical variables. Twenty-two subjects with bimalleolar ankle fractures and eleven healthy subjects were included in the study. Data collection was performed at 6 and 12 months after surgery and included clinical measurements (ankle dorsiflexion range of motion and bimalleolar/calf circumference), functional scales (AOFAS and OMAS), and dynamic plantar pressure analysis. The main results found in plantar pressure were a lower mean/peak plantar pressure, as well as a lower contact time at 6 and 12 months with respect to the healthy leg and control group and only the control group, respectively (effect size 0.63 ≤ d ≤ 0.97). Furthermore, in the ankle fracture group there is a moderate negative correlation (−0.435 ≤ r ≤ 0.674) between plantar pressures (average and peak) with bimalleolar and calf circumference. The AOFAS and OMAS scale scores increased at 12 months to 84.4 and 80.0 points, respectively. Despite the evident improvement one year after surgery, data collected using the pressure platform and functional scales suggest that recovery is not yet complete.

Three-dimensional gait analysis of orthopaedic common foot and ankle joint diseases

“…A study of dynamic plantar pressure changes at 6 and 12 months after bilateral ankle fracture surgery showed that AFG patients had lower plantar pressure (peak and mean) and longer contact time than did CG patients and that AFG patients had significantly lower e-cadence and gait speed than did the control group. Similarly, (Fernández-Gorgojo et al, 2023), Zhu et al (2022) reported similar results in a study of 12 subjects after trimalleolar fracture; i.e., abnormal changes in plantar pressure were mainly manifested in the forefoot and hindfoot regions. Compared with those in the healthy control group, the patients in the symptomatic group had shorter step lengths, larger step widths, slower walking speeds, shorter single supports and obvious asymmetry in gait; these authors believe that these differences might be related to functional impairment of the anterior tibial and peroneal longus muscle ability.…”