Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaan Xi Province, China.
Department of Pathology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaan Xi Province, China.
Sci Rep. 2018 Apr 19;8(1):6270. doi: 10.1038/s41598-018-24737-w.
Recent trends have led to an interest in Ponseti treatment for correcting neglected congenital clubfoot. Although good clinical and functional outcomes have been reported, the plantar pressure distribution after the treatment of neglected clubfoot has not been explored yet. The present study aimed to investigate whether plantar pressures normalized following Ponseti treatment in patients with neglected congenital clubfoot. Pedobarographic, clinical, and functional examinations were performed in 22 children (aged, 91.0 ± 40.3 months) with unilateral neglected congenital clubfeet, treated using Ponseti method at 27.8 ± 12.1 months of age. Plantar pressure parameters were recorded using a Footscan pressure plate. The contact time, contact area, peak pressure, and pressure-time integral were determined. The data of the affected feet were compared with those of the unaffected feet and healthy controls. Although clinical and functional examinations showed satisfactory results according to the Dimeglio and Pirani scores, considerable differences in plantar pressure parameters were identified among the affected feet, unaffected feet, and healthy controls. Internal foot progression angle and a load transfer from the medial forefoot and hindfoot to the lateral forefoot and midfoot were observed in the affected feet. Future studies should attempt to investigate the factors accounting for plantar pressure deviations and the possible effect of these deviations on the lower limb musculoskeletal development of children.
最近的趋势引起了人们对 Ponseti 治疗方法矫正先天性马蹄内翻足的兴趣。尽管已经报道了良好的临床和功能结果,但尚未探讨治疗先天性马蹄内翻足后的足底压力分布。本研究旨在探讨 Ponseti 治疗后是否能使先天性马蹄内翻足患者的足底压力正常化。对 22 例(年龄 91.0±40.3 个月)单侧先天性马蹄内翻足患儿采用 Ponseti 法治疗,于 27.8±12.1 个月时采用 Footscan 压力板进行足底压力参数测量,同时进行足踝临床和功能检查。记录接触时间、接触面积、峰值压力和压力时间积分。将患足数据与健足和健康对照组进行比较。虽然根据 Dimeglio 和 Pirani 评分,临床和功能检查显示出满意的结果,但患足与健足和健康对照组之间的足底压力参数仍存在显著差异。患足存在内翻角度,前足和后足的负荷从前内侧转移到前外侧和中足。未来的研究应尝试探讨导致足底压力偏差的因素,以及这些偏差对儿童下肢骨骼肌肉发育的可能影响。
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