The role of gait analysis in planning reconstructive surgery

Abstract

Reconstructive surgery should restore normal structure and function to the anatomically injured body part. Therefore, it is imperative to familiarize oneself with normal gait and foot function if surgical reconstruction is undertaken. The foot is a quagmire of skin, muscles, tendons, ligaments, bones, nerves, and arteries that act as shock absorbers, load levelers, and propulsive mechanisms. When functioning normally, it can propel the human body when walking to 5 miles per hour, and when running, to 12 miles per hour. It can adapt to the vertical pressures of ballet, the horizontal forces of weightbearing on uneven terrain and even grip the narrow ledges of rock climbing. This resiliency of the foot is attributed to this complex integration of structures functioning sequentially and synchronously thousands of times per day. It truly is an underappreciated organ until pain or deformity render it useless. It has been estimated that a 150-lb person walking 1 mile generates up to 60 tons of force on each foot in normal gait. With the advent of computer-assisted gait evaluations many difficult patterns of gait have been more thoroughly analyzed. This has proved valuable in preoperative evaluation and in postoperative prosthetic and orthotic fabrication. We will attempt to outline the patterns of normal gait, normal functioning musculature, and techniques of gait analysis for the practicing plastic surgeon. Additionally the F-scan (TEKSCAN, INC., South Boston, MA) pressure measuring system will be introduced.