Effect of Plano-Valgus Foot on Lower-Extremity Kinematics and Spatiotemporal Gait Parameters in Children of Age 5–9

Aim of the study was to see how a definition of the flexible flat foot (FFF) influences the results of gait evaluation in a group of 49 children with clinically established FFF. Objective gait analysis was performed using VICON system with Kistler force platforms. The gait parameters were compared between healthy feet and FFF using two classifications: in static and dynamic conditions. In static condition, the ink footprints with Clarke’s graphics were used for classification, and in dynamic condition, the Arch Index from Emed pedobarograph while walking was used for classification. When the type of the foot was based on Clarke’s graphics, no statistically significant differences were found. When the division was done according to the Arch Index, statistically significant differences between flat feet and normal feet groups were found for normalized gait speed, normalized cadence, pelvic rotation, ankle range of motion in sagittal plane, range of motion of foot progression, and two parameters of a vertical component of the ground reaction force: FZ2 (middle of stance phase) and FZ3 (push-off). Some statically flat feet function well during walking due to dynamic correction mechanisms.

New anatomical reference systems for the bones of the foot and ankle complex: definitions and exploitation on clinical conditions

Background A complete definition of anatomical reference systems (ARS) for all bones of the foot and ankle complex is lacking. Using a morphological approach, we propose new ARS for these bones with the aim of being highly repeatable, consistent among individuals, clinically interpretable, and also suited for a sound kinematic description. Methods Three specimens from healthy donors and three patients with flat feet were scanned in weight-bearing CT. The foot bones were segmented and ARS defined according to the proposed approach. To assess repeatability, intra class coefficients (ICC) were computed both intra- and inter-operator. Consistency was evaluated as the mean of the standard deviations of the ARS position and orientation, both within normal and flat feet. Clinical interpretability was evaluated by providing a quantification of the curvature variation in the medial-longitudinal and transverse arches and computing the Djiann-Annonier angle for normal and flat feet from these new ARS axes. To test the capability to also provide a sound description of the foot kinematics, the alignment between mean helical axes (MHA) and ARS axes was quantified. Results ICC was 0.99 both inter- and intra-operator. Rotational consistency was 4.7 ± 3.5 ° and 6.2 ± 4.4° for the normal and flat feet, respectively; translational consistency was 4.4 ± 4.0 mm and 5.4 ± 2.9 mm for the normal and flat feet, respectively. In both these cases, the consistency was better than what was achieved by using principal axes of inertia. Curvature variation in the arches were well described and the measurements of the Djiann-Annoier angles from both normal and flat feet matched corresponding clinical observations. The angle between tibio-talar MHA and ARS mediolateral axis in the talus was 12.3 ± 6.0, while the angle between talo-calcaneal MHA and ARS anteroposterior axis in the calcaneus was 17.2 ± 5.6, suggesting good capability to represent joint kinematics. Conclusions The proposed ARS definitions are robust and provide a solid base for the 3-dimensional description of posture and motion of the foot and ankle complex from medical imaging.

Assessment of flat foot using plantar arch index in young adults

Introduction and Aim: Flat foot or pes planus results from collapse of the arches of the foot. Etiology, however varies in different age groups. As anthropometric measurements are age dependent, their correlation with different foot postures should be age specific. Our study aimed at using Plantar arch Index (PAI) to identify prevalence of flat foot in a young student population and find any association of obesity with flat foot. Methods: A prospective study was conducted on 150 medical students of a medical college. Staheli’s method was used to calculate PAI after collecting the footprints of students by ink method. Results: Prevalence of type III flat foot deformity was 6%, with a male preponderance. The PAI values ranged from 0 to 1.818. No association was found between obesity and PAI. Conclusion: Obesity was not associated with flat foot in the age group 18-25 years probably indicating different etiology for acquired flat foot in this age group. Our study also suggests that simple ink print method is a simpler method to diagnose flat feet deformity clinically using PAI.

First metatarsal elevation after subtalar arthroeresis in children with flatfeet

BACKGROUND: Arthroereisis of the subtalar joint is a common surgical option for children with flat feet. Along with all the advantages of arthroereisis of the subtalar joint, the indications for surgery, the optimal age for surgical treatment, as well as secondary deformities of the forefoot that occur after treatment are debatable. AIM: The aim of this study was to analyze the frequency and degree of I metatarsal elevation after arthroereisis of the subtalar joint in children. MATERIALS AND METHODS: The study group included 106 patients / 202 feet who were treated at the H. Turner Pediatric Orthopedic Institute for the period from 2015 to 2019. The average age was 11 years (8; 13). Arthroereisis of the subtalar joint was performed in two variants: arthroereisis with a locking screw in the calcaneus 44 patients / 83 feet and arthroereisis with a locking screw in the talus 62 patients / 119 feet. An analysis was made of the incidence of I metatarsal elevation after arthroereisis of the subtalar joint. The relationship between the degree of elevation of the first metatarsal bone and the main clinical and radiological characteristics of the feet at different times after surgical treatment was analyzed. RESULTS: The frequency of elevation of the I metatarsal bone with the use of a calcaneal locking screw was 20.7%, and with the use of a talar locking screw, the frequency is 51.6%. Clinical manifestations of elevation of the I metatarsal bone took place when the amount of elevation was more than 65% of the size of the head of the I metatarsal bone. At a period of 23 years after the operation, elevation of the I metatarsal bone were noted in 15.9%. A statistically significant correlation (Spearman coefficient) was noted between the degree of elevation of the I metatarsal bone and the following parameters: anteroposterior Meary angle (0.360), lateral Kite angle (0.367), lateral Meary angle (0.378), foot arch angle (0.344), tibio-talar angle (0.351), Friedlands index (0.402). CONCLUSIONS: Incidence of the first metatarsal bone elevation reaches 51% of the in patients in the immediate follow-up period after performing arthroereisis of the subtalar joint. Elevation of the first metatarsal bone developed dorsal bunion with an elevation value of more than 65%. The degree of elevation of the first metatarsal bone has a positive correlation with the degree of planovalgus deformity correction. Elevation of the first metatarsal bone tends to decrease up to 15% in the long-term follow-up after surgical treatment.

Relationship of Body Mass Index and Footprint Morphology to the Actual Height of the Medial Longitudinal Arch of the Foot

The medial longitudinal arch height of the foot is linked to individual characteristics such as sex and body mass index, and these characteristics have been shown to be associated with conditions such as flat feet. In this cross-sectional descriptive study, we examined the medial longitudinal arch morphology in an adult population to determine if there are differences related to sex and body mass index, and values were obtained for the foot posture index. Normalized anthropometric measurements and arch indices were calculated from footprints. Groups, defined by sex and body mass index, were compared, and the correlations between body mass index and the variables were determined. In the population studied (266 women and 177 men), significant differences between men and women for the foot posture index and normalized arch measurements were found. Analysis of the variables related to body mass index indicated there were significant differences in arch indices. Significant differences and positive correlations were also found between the arch index and body mass index for the left and right feet among the men and women studied. The results obtained allow us to reflect on and analyze whether the medial longitudinal arch morphology classification methods used in the clinical and research setting are adequate or whether the influence of factors such as body mass index can generate confusion.

Treatment of spastic flat feet. H. Meyer (Arch. F. Orthop. U. Unf. Chir., 1926. Bd 24, H. 1).

H. Meyer (Arch. F. Orthop. U. Unf.-Chir. 1926 Bd 24, H. 1). proposes to turn off the function of the peroneal muscle group for this purpose. Pronators and extensors in a spastic flat foot become overworked due to prolonged overstretching.

Comparison of Plantar Force, Pressure and Impulse During Walking in Men and Women With Flat Feet

Objective: This study aims to compare the variables of plantar force, pressure and impulse during walking in men and women with flat feet. Methods: The study population consists of non-athlete students with and without flat feet. Of these, 48 (male and female) were selected as study samples. The peak pressure, force and impulse on the foot were measured during walking by a foot scanner at a sampling frequency of 253 Hz. Shapiro-Wilks test was used to examine the normality of data distribution, and data analysis was performed using MANOVA in SPSS software, considering the significance level at P<0.05. Results: Men with flat feet had more peak plantar pressure and force in the midfoot than healthy men, and more peak plantar pressure on the hallux. Women with flat feet had more peak plantar pressure and force on the hallux, toes T2-T3-T4-T5, M2 metatarsal head, and midfoot than healthy women. Men with flat feet had peak plantar pressure on the M4 metatarsal head than women with flat feet. Men with flat feet had different plantar impulses in the hallux, M2 metatarsal head, and lateral heal. Women with flat feet had more plantar impulses in the hallux, toes T2-T3-T4-T5, and midfoot than healthy women. There was a significant difference between men and women with flat feet in plantar impulses in metatarsal heads M3 and M4, midfoot, and lateral and medial heels Conclusion: Different effects of gender and sole structure on the distribution of plantar pressure should be considered in the production and design of shoes, medical insoles and special sports footwear.