Sinha Shivam, Song Hae Ryong, Kim Hak Jun, Park Man Sik, Yoon Yeoung Chool, Song Sang Heon
Department of Orthopaedics, Rare Disease Institute, Guro Hospital, KUMC, Seoul, South Korea.
J Orthop Surg (Hong Kong). 2013 Apr;21(1):37-43. doi: 10.1177/230949901302100111.
To evaluate any correlation between various foot angles and their respective American Orthopaedic Foot and Ankle Society (AOFAS) scores for pain, and the effectiveness of a medial arch orthosis.
81 children with bilateral symptomatic flatfoot were randomised into orthosis (n=55) and control (n=26) groups. The orthosis group consisted of 33 male and 22 female patients aged 36 to 204 (mean, 99) months and they were given a medial arch support. The control group consisted of 15 male and 11 female patients aged 36 to 192 (mean, 100) months and they were managed with analgesics. Foot angles including anteroposterior (AP) and lateral talocalcaneal (TC) angles, AP and lateral talo- first metatarsal (TFM) angles, calcaneal pitch angle (in lateral plane), and talonavicular (TN) angle were measured, as were AOFAS scores for pain for the forefoot, midfoot, and hindfoot.
After orthosis treatment, all AOFAS scores and all foot angles (except for the AP-TN angle) improved significantly. In the controls, all AOFAS scores (except for the midfoot score) and only the AP-TFM angle improved significantly. In the orthosis group, the AOFAS hindfoot score correlated positively with the lateral TC angle of the left foot (r=0.345, p=0.010) and negatively with the calcaneal pitch angle of the right foot (r=-0.33, p=0.015). In the control group, the lateral TFM angle of the left foot correlated negatively with the AOFAS forefoot (r=-0.566, p=0.003) and midfoot scores (r=-0.497, p=0.001), whereas the calcaneal pitch angle of the left foot correlated positively with the AOFAS forefoot score (r=0.497, p=0.010).
Medial arch support orthosis significantly improved AOFAS scores and foot angles. Calcaneal pitch angle and lateral TC angle correlated well with AOFAS hindfoot scores.
评估各种足部角度与其各自的美国矫形足踝协会（AOFAS）疼痛评分之间的相关性，以及内侧足弓矫形器的有效性。
81例双侧有症状扁平足儿童被随机分为矫形器组（n = 55）和对照组（n = 26）。矫形器组包括33例男性和22例女性患者，年龄36至204（平均99）个月，为其提供内侧足弓支撑。对照组包括15例男性和11例女性患者，年龄36至192（平均100）个月，采用镇痛药治疗。测量足部角度，包括前后（AP）和外侧距跟（TC）角、AP和外侧距第一跖骨（TFM）角、跟骨倾斜角（在侧平面）以及距舟（TN）角，同时测量前足、中足和后足的AOFAS疼痛评分。
矫形器治疗后，所有AOFAS评分和所有足部角度（除AP - TN角外）均显著改善。在对照组中，所有AOFAS评分（除中足评分外）和仅AP - TFM角显著改善。在矫形器组中，AOFAS后足评分与左脚外侧TC角呈正相关（r = 0.345，p = 0.010），与右脚跟骨倾斜角呈负相关（r = -0.33，p = 0.015）。在对照组中，左脚外侧TFM角与AOFAS前足（r = -0.566，p = 0.003）和中足评分（r = -0.497，p = 0.001）呈负相关，而左脚跟骨倾斜角与AOFAS前足评分呈正相关（r = 0.497，p = 0.010）。
内侧足弓支撑矫形器显著改善了AOFAS评分和足部角度。跟骨倾斜角和外侧TC角与AOFAS后足评分相关性良好。
