MacMahon Aoife, Hillstrom Howard J, Do Huong T, Chan Jeremy Y, Deland Jonathan T, Ellis Scott J
Department of Foot and Ankle Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
Leon Root Motion Analysis Laboratory, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
HSS J. 2017 Jul;13(2):136-145. doi: 10.1007/s11420-017-9542-z. Epub 2017 Feb 28.
Intraoperative pedobarography has the potential to aid surgical decisions, but no parameters exist to guide its use.
QUESTIONS/PURPOSES: This study compared supine plantar pressures between flatfoot patients and controls using a previously validated intraoperative pedobarographic device and examined associations between supine, walking, and standing plantar pressures.
Ten preoperative patients with stage II adult-acquired flatfoot deformity (AAFD) were compared to ten healthy controls. Supine plantar pressures were assessed using the pedobarographic device. Standing and walking plantar pressures were assessed with an EMED-XT sensor array (Novel). Maximum force (MF) and peak pressure (PP) were calculated for nine anatomical foot regions adjusting for age and BMI.
No differences in plantar pressures were found between flatfoot patients and controls in the supine or standing positions. During walking, flatfoot patients had greater MF of the first, second, and third metatarsals ( ≤ 0.018) and greater PP of the first and second metatarsals than controls ( ≤ 0.010). Supine MF and PP were both strongly positively correlated with their respective pressure measurements for both standing and walking in multiple foot regions ( ≤ 0.05, all analyses). Correlations in the first metatarsal region were generally weak and not statistically significant.
This device did not show differences in supine plantar pressures of flatfoot patients and healthy subjects, highlighting the limitations of intraoperative devices in guiding flatfoot correction. The differences between flatfoot and controls during walking and the correlations between supine and walking conditions suggest that dynamic plantar pressures are a more useful parameter in guiding flatfoot reconstruction.
术中足底压力测量法有辅助手术决策的潜力，但尚无参数可指导其应用。
问题/目的：本研究使用先前验证过的术中足底压力测量设备，比较扁平足患者与对照组仰卧位时的足底压力，并研究仰卧位、行走和站立时足底压力之间的关联。
将10例术前患有II期成人获得性平足畸形（AAFD）的患者与10名健康对照者进行比较。使用足底压力测量设备评估仰卧位时的足底压力。使用EMED-XT传感器阵列（Novel公司）评估站立和行走时的足底压力。针对九个足部解剖区域计算最大力（MF）和峰值压力（PP），并对年龄和体重指数进行校正。
扁平足患者与对照组在仰卧位或站立位时的足底压力无差异。在行走过程中，扁平足患者第一、第二和第三跖骨的MF高于对照组（≤0.018），第一和第二跖骨的PP高于对照组（≤0.010）。仰卧位的MF和PP与多个足部区域站立和行走时各自的压力测量值均呈强正相关（≤0.05，所有分析）。第一跖骨区域的相关性通常较弱且无统计学意义。
该设备未显示扁平足患者与健康受试者仰卧位足底压力的差异，凸显了术中设备在指导扁平足矫正方面的局限性。扁平足与对照组在行走时的差异以及仰卧位与行走状态之间的相关性表明，动态足底压力是指导扁平足重建更有用的参数。
