Harris Mat Research Articles

Role of the peroneal tendons in the production of the deformed foot with posterior tibial tendon deficiency.

Ten patients were identified with traumatic, complete common peroneal nerve palsy, with no previous foot or ankle surgery or trauma distal to the knee, who had undergone anterior transfer of the posterior tibial tendon to the midfoot. Six of these patients had a transfer to the midfoot and four had a Bridle procedure with tenodesis of half of the posterior tibial tendon to the peroneus longus tendon. Average follow-up was 74.9 months (range, 18-351 months). All patients' feet were compared assessing residual muscle strength, the longitudinal arch, and motion at the ankle, subtalar, and Chopart's joint. Weightbearing lateral X-rays and Harris mat studies were done on both feet. In no case was any valgus hindfoot deformity associated with posterior tibial tendon rupture found. It seems that the pathologic condition associated with a posterior tibial tendon deficient foot will not manifest itself if peroneus brevis function is absent.

The Foot in Marfan Syndrome: Clinical Findings and Weight-Distribution Patterns

The feet of Marfan patients are typically described as pes planovalgus. We evaluated the single-leg-stance footprint of 124 feet in 63 patients with the Marfan syndrome by using pressure-sensitive film and a Harris mat. Forty feet in 21 people with no history of foot problems were evaluated as normal controls. The medial and lateral aspects of the fore-, mid-, and hindfoot were assessed. The midfoot was further analyzed by dividing the medial midfoot force by the total midfoot force. The mean medial midfoot force/total midfoot force (MM/TM) in the control population was 11.1% (SD, 6.5%). Pes planus was defined as the MM/TM force > 24.0% (mean + 2 SD). The mean MM/TM force in the Marfan group was not statistically different (16.0%) from controls. The distribution, however, revealed two distinct types of weight-bearing patterns. Of the Marfan group, 74.8% had medial forces within the standard distribution of the normal control population. Only 25.2% of the Marfan patients had forces that were outside the range of normal midfoot forces and were defined as pes planus. Analysis of the patient's ligamentous laxity and the foot function in the Marfan population revealed no statistically significant correlation to the type of weight-bearing pattern of the foot.

The foot in Marfan syndrome: clinical findings and weight-distribution patterns.

The feet of Marfan patients are typically described as pes planovalgus. We evaluated the single-leg-stance footprint of 124 feet in 63 patients with the Marfan syndrome by using pressure-sensitive film and a Harris mat. Forty feet in 21 people with no history of foot problems were evaluated as normal controls. The medial and lateral aspects of the fore-, mid-, and hindfoot were assessed. The midfoot was further analyzed by dividing the medial midfoot force by the total midfoot force. The mean medial midfoot force/total midfoot force (MM/TM) in the control population was 11.1% (SD, 6.5%). Pes planus was defined as the MM/TM force > 24.0% (mean + 2 SD). The mean MM/TM force in the Marfan group was not statistically different (16.0%) from controls. The distribution, however, revealed two distinct types of weight-bearing patterns. Of the Marfan group, 74.8% had medial forces within the standard distribution of the normal control population. Only 25.2% of the Marfan patients had forces that were outside the range of normal midfoot forces and were defined as pes planus. Analysis of the patient's ligamentous laxity and the foot function in the Marfan population revealed no statistically significant correlation to the type of weight-bearing pattern of the foot.

5 Determination of novel pedar masks using harris mat imprints

5 Determination of novel pedar masks using harris mat imprints

Reconstruction of Foot Injuries

Foot injuries constitute a spectrum of problems that can be classified by severity. The development of successful techniques for the treatment of lower leg injuries has made the severity of a concomitant foot injury a key factor in determining the overall salvageability of the leg. A more complete classification of foot injuries is therefore needed and has been proposed. Preoperative assessment of foot injuries differs in the acute versus the delayed presentation. The acute case requires evaluation of wound conditions, exposed structures, and associated proximal injuries. The chronic injury requires gait analysis, study of weight-bearing patterns by Harris mat prints, skeletal evaluation, mapping of plantar sensation, and, in some cases, angiography. Thorough knowledge of foot anatomy is essential for developing a rational plan for treatment. The significance and course of the medial calcaneal nerve and the anatomy of the plantar nerves have not been fully appreciated in most reports on the treatment of foot injuries. The recognition of the proximal plantar subcutaneous plexus blood supply has modified the understanding of plantar flap design. It has simplified and improved the safety of dissection of sensate plantar flaps. A plethora of both local and distant flap options exist for the treatment of foot injuries. The foot is divided into four major areas based on different requirements for reconstruction and the types of flaps available. These areas are the proximal plantar area; the malleoli, Achilles tendon, and posterior (non-weight-bearing) heel area; the distal plantar area; and the dorsum. The options for coverage have been discussed in detail, and a summary of the reconstructive strategy by area has been presented in Table 3. Complex (type III) injuries are special injuries owing to their severity and multiple components. They require a careful initial evaluation for both feasibility and advisability of extremity salvage. Treatment of these injuries consists of bony stabilization and soft-tissue debridement followed by flap coverage.

Survey of foot deformities among 166 geriatric inpatients.

A clinical survey on foot deformities among 166 geriatric inpatients was carried out. Direct measurements on hallux valgus, great toe movements, great toe deformities, lesser toe deformities, arch of the foot, callosities, ankle movements, inversion, and eversion were done by using the goniometer. A specially designed goniometer was created to measure inversion and eversion. The Harris Mat was used to study foot prints in correlation with the various deformities. About 50% of geriatric patients were found to have foot deformities of various types. This compared well with available data in literature. The target population was also checked for their symptomatology which, amazingly, was found to be really insignificant compared with the deformities present. This finding was found to be very much unlike data for Caucasian individuals with foot deformities, 50% of whom had symptoms related to pain and footwear. This major difference in the clinical presentation encourages the authors to carry on their study and, perhaps, direct cross-cultural studies in the future.

Evaluation of sensibility and function with microsurgical free tissue transfer of the great toe to the hand for thumb reconstruction

Detailed evaluation of sensibility and function on 10 patients was carried out on an average of 42 months after thumb reconstruction by microsurgical free tissue transfer. Sensibility based on modified two-point discrimination and ridge criteria was found to be directly related to the patient's age at time of neurosuture. The plantar aspect of the distal 2 cm of the normal toe showed two-point value averaging 6 mm in 20 normal shoe-wearing adults, compared to values of 12 mm when the toe was tested over the plantar surface of the proximal half of the distal phalanx. Metacarpophalangeal joint motion and interphalangeal joint motion were limited when compared with the opposite normal thumb and unoperated great toe. Grip strength and pinch strength reflected the degree of associated injuries in the hand. Cold intolerance was present in all patients. Patients' subjective assessment of their ability to use their hand as compared to their hand prior to injury was rated at less than 10% preoperatively compared to 52% to 87% postoperatively. None of the patients perceived a problem of social acceptance after the surgery. Postoperative studies of the feet revealed concentration of weight bearing between the second and third metatarsal heads on Harris mat studies and slowing of the forward and medial progression of the center of pressure on gait analysis. Some weakness in push-off and cutting maneuvers in sports activities was reported in half of the patients. None of the patients experienced difficulty when running long distances on level ground. All the patients returned to gainful employment postoperatively.

Amputation of the great toe.

Four patients who had undergone reimplantation of the great toe to create a thumb were studied. The follow-up period ranged from 29 to 62 months. In all cases, the great toe was disarticulated at the metatarsophalangeal joint. The patients felt their feet functioned at approximately 85% of normal, and none had any significant complaint of metatarsalgia. The one patient who participated in sports after the surgery noted that it was difficult to "push off" moving away from the involved foot. X-ray examination demonstrated retraction of the sesamoids, which accounted for the increased plantar flexion of the first metatarsal shaft. The second metatarsophalanageal joint drifted into varus an average of 8 degrees. The Harris mat demonstrated that there was an increase in weightbearing beneath the second and third metatarsal heads. It appears as though, on the basis of this study, the loss of the great toe in this manner does not significantly affect the normal everyday function of an individual's foot.

Plantar Pressure Measurements

Objective measurements of forefoot plantar pressure were taken on 25 patients with rheumatoid arthritis. The Harris mat footprint test and the Brand slipper sock test were used to assess both compressive and shearing forces. The Harris mat footprint test is a static test used when the patient is unshod. The Brand slipper sock test is a dynamic test used while the shoe is worn. An experimental sandal was designed and used for the treatment of symptomatic forefoot callosities. The Harris mat footprint test results improved dramatically after the patients had worn an experimental sandal for six months. The Brand slipper sock test results showed marked diminution in the pressure profile while the patients wore the experimental sandal. All of the patients improved in their functional abilities while wearing the experimental sandal. (<i>JAMA</i>235:1138-1139, 1976)

Plantar pressure measurements. Rational shoe-wear in patients with rheumatoid arthritis

Objective measurements of forefoot plantar pressures were taken on 25 patients with rheumatoid arthritis. The Harris mat footprint test and the Brand slipper sock test were used to assess both compressive shearing forces. The Harris mat footprint test is a static used when the patient is unshod. The Brand slipper sock test is a dynamic test used while the shoe is worn. An experimental sandal was designed and used for the treatment of symptomatic forefoot callosities. The Harris mat footprint test results improved dramatically after the patients had worn an experimental sandal for six months. The Brand slipper sock test results showed marked diminution in the pressure profile while the patients wore the experimental sandal. All of the patients improved in their functional abilities while wearing the experimental sandal.