Kim Sungjoon, Kim Yong Gyun, Kim Jun Yup, Park Si-Bog, Lee Kyu Hoon
Department of Rehabilitation Medicine, Hanyang University Medical Center, Hanyang University College of Medicine, Seoul, Korea.
Ann Rehabil Med. 2024 Oct;48(5):352-359. doi: 10.5535/arm.240041. Epub 2024 Oct 31.
To investigate longitudinal changes in plantar pressure examinations and plain radiographs and to assess the correlations between these two modalities in pediatric patients with flexible flatfoot (FFF).
Pediatric patients diagnosed with FFF were analyzed in this retrospective cohort study. Medical records were reviewed to collect data on plain radiographs and plantar pressure examinations. Changes in radiographic angles and plantar pressure parameters were analyzed over a follow-up period exceeding 1 year. Statistical analyses included paired t-test, Wilcoxon signed rank test, and Spearman's correlation analysis.
A total of 52 subjects was included in the plantar pressure analysis, with a mean age of 9.9 years at the first visit and a median follow-up duration of 52 months. The lateral tarso-first metatarsal angle decreased by 1.3° (p<0.001) and calcaneal inclination angle increased by 2.5° (p<0.001) in these patients. The percentage value of midfoot width (WMF) divided by forefoot width (WFF) decreased by an average of 9.8% p (p<0.001), and the maximal pressure on the medial midfoot (MMF) decreased by 1.6 N/cm2 (p<0.001). However, no correlations were found between plantar pressure and radiographic changes.
During follow-up of patients with FFF, the maximal pressure on the MMF and the ratio of WMF to WFF decreased in successive plantar pressure examinations. Changes observed in plantar pressure and plain radiographs were not consistent, indicating that these two testing modalities can complement each other.
研究柔韧性扁平足（FFF）患儿足底压力检查和X线平片的纵向变化，并评估这两种检查方法之间的相关性。
在这项回顾性队列研究中，对诊断为FFF的患儿进行分析。查阅病历以收集X线平片和足底压力检查的数据。在超过1年的随访期内分析影像学角度和足底压力参数的变化。统计分析包括配对t检验、Wilcoxon符号秩检验和Spearman相关性分析。
共有52名受试者纳入足底压力分析，首次就诊时平均年龄为9.9岁，中位随访时间为52个月。这些患者的外侧跗骨-第一跖骨角减小了1.3°（p<0.001），跟骨倾斜角增加了2.5°（p<0.001）。足中宽度（WMF）与前足宽度（WFF）的百分比值平均下降了9.8%（p<0.001），足中内侧（MMF）的最大压力下降了1.6 N/cm²（p<0.001）。然而，未发现足底压力与影像学变化之间存在相关性。
在FFF患者的随访过程中，连续的足底压力检查显示MMF的最大压力以及WMF与WFF的比值下降。足底压力和X线平片观察到的变化不一致，表明这两种检查方法可以相互补充。
