The need for biomechanical evaluation in the assessment of clubfoot

Herd, F.; Macnicol, Malcolm F.; Abboud, Rami

doi:10.1016/j.foot.2003.12.004

Cited by 25 publications

(17 citation statements)

References 24 publications

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“…The evaluation of congenital clubfoot allows an initial classification of the deformation and an estimate of the treatment success rate. Previous research has shown that the treatment result will depend on the initial deformation degree (1,2); thus, the classification can help define the prognosis. Data quantification allows comparisons and facilitates monitoring of the treatment success and the progression or regression of the deformation.…”

mentioning

confidence: 99%

A Clinical Evaluation of the Pirani and Dimeglio Idiopathic Clubfoot Classifications

Cosma¹,

Vasilescu

2015

The Journal of Foot and Ankle Surgery

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confidence: 99%

A Clinical Evaluation of the Pirani and Dimeglio Idiopathic Clubfoot Classifications

Cosma¹,

Vasilescu

2015

The Journal of Foot and Ankle Surgery

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“…These techniques consider the foot in a static state, are difficult to quantify, and suffer to a large extent from the subjectivity of the observer. 3,4 They are not adequate when one wishes to obtain information on the dynamic functional state of the foot, 5Y8 which is certainly one of the most important aspects to consider when assessing the effects of a therapeutic intervention. Hee et al 2 stated that goodlooking and apparently well-functioning clubfeet were not entirely normal according to a more objective biomechanical analysis.…”

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confidence: 99%

“…9 It is the only means to assess the function of the foot objectively while the subject is walking. 3 To compare the values of foot pressure of an operated clubfoot collective, reference values from normal healthy feet are needed. Unfortunately, comparison with data found in the literature 10Y12 is confusing and difficult to implement because the measurements are influenced by several parameters.…”

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confidence: 99%

The Contralateral Foot in Children With Unilateral Clubfoot

Favre¹,

Exner²,

Drerup³

et al. 2007

Journal of Pediatric Orthopaedics

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The unaffected contralateral side of patients with unilateral clubfeet has sometimes been taken as control in foot pressure measurement studies. However, it has never been shown that the pressure pattern under the contralateral foot is similar to a normal foot. Sixteen patients with unilateral clubfoot and 110 normal subjects took part in this study. All participants were aged from 4 to 8 years. Studies comprised clinical examination and foot pressure measurements in barefoot walking. Evaluations of the measurements were completed by the calculation of forces acting under 10 anatomical foot areas normalized to ground reaction force at foot-flat and push-off. Significant differences in peak pressure were observed between the control group and the contralateral foot of patients under the heel and the metatarsals 1 to 4. Significant differences in the forces at foot-flat and push-off are seen especially in the midfoot. Both sides of the patients with unilateral clubfeet exert significantly less ground reaction force than normal subjects. Different pressure and force distributions of clubfoot children on their contralateral side compared with the normal feet of the control group may indicate differences in the general control pattern generated by the central nervous system. Differences can still be observed after normalization of the forces. We therefore conclude that when foot pressure measurements are made with clubfeet, it might be advisable to use a collective of normal feet, instead of the contralateral foot, for comparison.

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“…Nowadays, modern methods such as micro-CT, CT, MRI and Doppler ultrasound (Cooke et al 2008) tend to study the tissue directly with in vivo potential. The results are either used for 3D models, for instance for custom orthosis (Vijayaragavan et al 2014), clubfoot surgical model (Windisch et al 2007) or for comparison with foot pressure and gait biomechanical analysis at clubfoot (Herd et al 2004). This combination of methods was able to reveal some functional abnormalities even at corrected and well-functioned clubfoot (Hee et al 2001).…”

Section: Classification Methods and Biomechanical Indicatorsmentioning

confidence: 99%

Possible Pathogenetic Mechanisms and New Therapeutic Approaches of Pes Equinovarus

Ošťádal

Lišková²,

Hadraba³

et al. 2017

Physiol Res

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Idiopathic pes equinovarus (clubfoot) is a congenital deformity of the foot and lower leg defined as a fixation of the foot in plantar flexion, adduction, supination and varus. The deformity does not affect only the foot position, which is usually investigated by radiography, CT, micro-CT, MRI or ultrasound but logically influence the whole gait biomechanics. It is supposed, that clubfoot belongs to a group of fibroproliferative disorders whose origin and multi-hierarchical effect remain unknown. It has been suggested that fibroblasts and growth factors may be involved. To gain a more global view, direct analysis of the protein composition of extracellular matrix, a proteomic approach was used. At present two principle methods are mostly used for the treatment of clubfoot: physiotherapy and the Ponseti method. The determination of the general biological and biomechanical parameters for various regions of the clubfoot can potentially help in the understanding of the mechanisms participating on this serious anomaly and thus contribute to the development of the more efficient therapeutic approach. This review summarizes the present knowledge on the possible pathogenetic mechanisms participating in the development of the clubfoot and their possible relation to the new therapeutic approaches.

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The need for biomechanical evaluation in the assessment of clubfoot

Cited by 25 publications

References 24 publications

A Clinical Evaluation of the Pirani and Dimeglio Idiopathic Clubfoot Classifications

A Clinical Evaluation of the Pirani and Dimeglio Idiopathic Clubfoot Classifications

The Contralateral Foot in Children With Unilateral Clubfoot

Possible Pathogenetic Mechanisms and New Therapeutic Approaches of Pes Equinovarus

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