Abstract

Objective To study the changes of gait and plantar pressure after various thumb/finger recontruction with different techniques. Methods Gait analyses and dynamic plantar pressure measurements bv F-scan system were performed to patients who underwent various thumb/finger reconstrction with different techniques. Results Thiny-eight patiertts who underwent various thumb/finger reconstruction were followed up,with a mean period of 25 months(4 to 182 months),and given gait analysis.In 10 cases the thumbs were reconstructed with the traditional wrap-around flap.Their Theit cycle and sub-phase of double support of the donor foot had the trend of prolonging compared with those of the intact foot.The peak force and peak pressure greatly increased in some donor great toes, but distinctly decreased,even undetectable for some others.The peak pressure under the 3rd and 4th metatarsal head of the donor foot significantly increased,as well as the peak force.The range that the center of force trajectory moved forward diminished signitlcantly.In 18 cases,the thumbs were recontructed with the modified wrap-around flap.The peak force and pressure-time integral of donor toes were both decreased statistically.but the peak, pressure was nearly the same to that of the intact toes.The duration of the gait cycle and its sub-phases,together with the peak force,peak pressure and pressure-time intecral under the 1st to 5th metalamtl heads had no difference between the donor and the intact foot.The center of fonce traieetory was almost the same on both sides.The kinematic and kinetic parameters of the donor foot were all changed to some extent after other reconstructive procedures.Conclusion Each thumb/finger reconstructive technique may cause certain degree of influence to the kinematics and kinetics of the donor foot. The traditional wrap-around technique brings significant changes,while the modified wrap-around technique has minor trouble to the donor foot function. Key words: Thumb; Foot; Gait; Reconstructive surgical procedures

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