Abstract
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.
Highlights
The main treatment of NCF is surgery, which consists of an extensive soft tissue release, tibialis anterior tendon transfer, different bony osteotomies, or even different types of external fixators[7,8,9,10]
Successful clinical outcomes were achieved in patients after the Ponseti treatment, defined as substantially improved Dimeglio and Pirani scores[16]
Residual deviations in plantar pressures were still observed in these patients
Summary
The main treatment of NCF is surgery, which consists of an extensive soft tissue release, tibialis anterior tendon transfer, different bony osteotomies, or even different types of external fixators[7,8,9,10]. The examinations primarily focused on the range of foot motion in different planes, esthetics, muscle condition, pain relief, palpation result, bone realignment, or patient and family satisfaction These assessments have some limitations: first, they consider the foot in a static state; second, they are difficult to quantify; and third, they suffer a certain degree of subjectivity[1,19]. They are not objective and comprehensive enough when the clinicians want the dynamic information of the foot, which is one of the most important aspects in evaluating the intervention outcomes[20,21] Pedobarographic analysis alleviates this problem and has proved to be a reliable clinical tool for quantifying the dynamic foot plantar pressure[22].
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