Gait Analysis Laboratory, Musgrave Park Hospital, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK.
Gait Posture. 2014;39(1):321-7. doi: 10.1016/j.gaitpost.2013.07.119. Epub 2013 Aug 6.
The Ponseti technique for treatment for Congenital Talipes Equinovarus (CTEV) was introduced in the authors' institution in 2001, substituting a more traditional orthopaedic approach which involved surgery. There is currently limited published information regarding the differences in clinical outcomes between these two techniques, particularly in relation to plantar pressure analysis. This study aims to determine differences in pedobarographic outcome in children with CTEV, treated with either a surgical or Ponseti approach. A high resolution pedobarograph was used to record plantar pressure distribution in 52 children with CTEV and 26 children with typical development. Data were imported into Matlab where a custom programme was developed for processing and analysing pedobarographic recordings. There were significant differences in both treatment groups compared to the typically developed group (p<0.05) for most measurements. The most salient differences between treatment groups were (i) at the hind-foot where the Ponseti group had significantly lower maximum peak pressures (p<0.05); (ii) at the lateral mid-foot where children treated by the Ponseti approach showed significantly larger peak force (p<0.001), average peak pressure (p<0.001) and maximum peak pressure (p<0.01); (iii) at the lateral fore-foot where the surgical group showed lower average peak pressure (p<0.05); and (iv) in the medial/lateral fore-foot ratio where the Ponseti group showed significantly lower values (p<0.05). Plantar pressure analysis is a complementary measurement for the assessment of gait in children with CTEV. Data presented in this study showed that while there were deviations in children with CTEV, the differences observed between treatment groups suggest children in the Ponseti group have some level of under correction or recurrence.
潘塞提技术治疗先天性马蹄内翻足(CTEV)于 2001 年在作者所在机构引入,取代了更传统的涉及手术的矫形方法。目前,关于这两种技术临床结果差异的信息有限,特别是在足底压力分析方面。本研究旨在确定接受手术或潘塞提方法治疗的 CTEV 儿童的足底压力分析结果差异。使用高分辨率足底压力计记录 52 例 CTEV 儿童和 26 例典型发育儿童的足底压力分布。数据导入 Matlab 后,开发了一个自定义程序用于处理和分析足底压力记录。与典型发育组相比,两组治疗组的大多数测量值均有显著差异(p<0.05)。两组治疗组之间最显著的差异为:(i)在足跟,潘塞提组的最大峰值压力显著降低(p<0.05);(ii)在中足外侧,潘塞提治疗组的峰值力显著增大(p<0.001),平均峰值压力(p<0.001)和最大峰值压力(p<0.01);(iii)在中足前外侧,手术组的平均峰值压力较低(p<0.05);以及(iv)在内外前足比值中,潘塞提组的比值明显较低(p<0.05)。足底压力分析是评估 CTEV 儿童步态的一种补充测量方法。本研究提供的数据表明,虽然 CTEV 患儿存在偏差,但治疗组之间观察到的差异表明,潘塞提组患儿存在一定程度的矫形不足或复发。