Medial Foot Research Articles

MCL augmentation using a peroneus longus split tendon autograft satisfactorily restores knee stability with no impairment in foot function and with a low failure rate for concurrent ACL reconstruction.

Addressing grade 2 and 3 medial-sided instabilities during anterior cruciate ligament (ACL) reconstruction is crucial to reduce the risk of ACL graft failure. This study introduced a minimally invasive, medial collateral ligament (MCL) augmentation technique using a peroneus longus split tendon autograft, which was fixed to the femoral deep MCL insertion and tibial superficial MCL insertion. This prospective, longitudinal, single-centre case series included patients who underwent MCL augmentation concurrent with primary or revision ACL reconstruction due to anteromedial instability. Preoperatively and at 1-year follow-up, clinical examinations, such as rolimeter test of anterior tibial translation and medial instability, knee (International Knee Documentation Committee subjective knee form [IKDC], Lsyholm, Knee Injury and Osteoarthritis Outcome Score [KOOS]) and foot function scores (American Orthopaedic Foot and Ankle Society score [AOFAS]) and complications, were analyzed. Thirty-one patients with a mean follow-up of 13.5 ± 2.6 months and a mean age of 27.8 ± 9.6 years were included. The side-to-side difference for anterior tibial translation significantly improved from preoperative to 1-year follow-up with an ACL reconstruction failure rate of 6.5%. No patient retained a grade 2 or 3 medial instability on valgus stress testing with 30° flexion. Significant improvements from preoperative to 1-year postoperative follow-up were observed in knee function scores: IKDC (48.9 ± 26.9- 71.3 ± 11.5, p < 0.001) and Lysholm (59.9 ± 28.5-80.5 ± 11.2, p = 0.002) as well as KOOS pain, ADL, sport and QoL, each reaching the respective minimal clinically important difference values. The foot function score AOFAS showed no significant impairment (100 ± 0-99.3 ± 2.5, p = 0.250). Complications included cyclops lesions of ACL reconstruction in three patients. At 1-year follow-up, MCL augmentation using a peroneus longus split tendon autograft for patients simultaneously undergoing ACL reconstruction satisfactorily restores knee stability, has a low ACL reconstruction failure rate and does not significantly impair foot function. Level IV therapeutic study; case series.

Impact of chronic ankle instability on gait loading strategy in individuals with chronic ankle instability: a comparative study

BackgroundLateral ankle sprains rank among the most prevalent musculoskeletal injuries, while chronic ankle instability (CAI) is its most common cascade. In addition to the conflicting results of the previous studies and their methodological flaws, the specific gait loading strategy is still not well studied.PurposeThe study aimed to investigate the fluctuations in gait loading strategy in people with chronic ankle instability compared to health control.MethodsA total of 56 male subjects participated in this study and were allocated into two groups: (A) CAI group: 28 subjects with unilateral CAI (age 24.79 ± 2.64 and BMI 26.25 ± 3.50); and (B) control group: 28 subjects without a history of ankle sprains (age 24.57 ± 1.17 and BMI 26.46 ± 2.597). Stance time, weight acceptance time, and load distribution were measured to investigate gait loading strategy.ResultsThe study findings revealed that the CAI group had a significant higher load over the lateral rearfoot. However, MANOVA indicates that there was no overall significant difference in gait loading strategy between the CAI and control groups. Furthermore, in terms of stance time, time of weight acceptance phase, load over medial foot, and load over lateral foot, CAI and healthy controls seemed to walk similarly.ConclusionsThe findings revealed that individuals with CAI had the significant alteration in the lateral rearfoot loading, suggesting a potential compensatory mechanism to address instability during the weight acceptance phase. This could manifest a laterally deviated center of pressure and increased frontal plane inversion during the early stance phase. However, it is acknowledged that these alterations could be both the result and the origin of CAI. The study highlights the vulnerability of CAI during the early stance phase, emphasizing the need for gait reeducation as individuals return to walking as healthcare clinicians should focus on treatment modalities aimed at reducing rearfoot inversion in individuals with CAI.

Effect of Medial Arch Support Foot Orthosis on Pressure Distribution and Peak Pressure in Women with Hallux Valgus

Effect of Medial Arch Support Foot Orthosis on Pressure Distribution and Peak Pressure in Women with Hallux Valgus

Comparison of Subjective and Biomechanical Outcomes Between Proprioceptive Training and Modified Broström-Gould Surgery for Chronic Ankle Instability: A Randomized Controlled Trial.

Both proprioceptive training and modified Broström-Gould surgery can improve ankle stability in patients with chronic ankle instability (CAI), but further biomechanical evaluation is necessary to determine the optimal treatment. To compare the clinical outcomes and biomechanical changes after proprioceptive training versus modified Broström-Gould surgery in patients with CAI. Randomized controlled trial; Level of evidence, 2. A total of 56 patients with CAI were assigned randomly to either a nonoperative group (n = 28) who underwent 3 months of proprioceptive training or an operative group (n = 28) who underwent modified Broström-Gould surgery. Foot and Ankle Ability Measure (FAAM) scores, foot pressure during walking, center of pressure (COP) velocity, and time for the COP to reach the balance boundary (time to boundary [TTB]) during single-leg standing were collected before the intervention (baseline) and at 3, 6, and 12 months after the intervention. Two-way repeated-measures analysis of variance was used to compare group differences and changes over time. The nonoperative group had significant improvements from baseline in FAAM-Sports score and significantly decreased TTB in both the anterior-posterior and medial-lateral directions at all timepoints, while the operative group showed significant improvements only in FAAM-Sports scores and TTB and COP velocity in the anterior-posterior direction at 6 and 12 months postintervention. During walking, the nonoperative group had significantly increased peak force under the medial foot at 3 months, which dropped back to baseline levels at 12 months, while the operative group had significantly increased peak force under the medial midfoot and hindfoot that persisted until 12 months (P < .05). In this study, both proprioceptive training and modified Broström-Gould surgery led to improved subjective functional scores, foot pressure distribution during walking, and postural stability during standing for patients with CAI but with different biomechanical patterns. Proprioceptive training led to an earlier recovery of sports function and better medial-lateral stability recovery, while surgery provided more persistent results. ChiCTR1900023999 (Chinese Clinical Trial Registry).

Pressure pain threshold of the whole foot: Protocol and dense 3D sensitivity map

When designing footwear products, designers and kinesiologists usually factor in plantar surface pressure, motion capture data, and subjective comfort evaluations. However, these factors alone are not sufficient to guide the design of truly comfortable shoes. Pressure pain threshold (PPT) is a parameter that establishes a connection between psychological quantities and physical quantities. The purpose of this study was to construct a high-precision PPT map of the whole foot. Overall, 20 participants were included in this study, and an electronic, mechanical algometer was used to apply constant pressure to the participants' feet. A MATLAB graphical user interface was developed to simplify the data-collecting process and generate visual representations of the data. Finally, several high-precision unisex, different sex, and dominant side PPT maps were generated. The findings revealed that the foot dorsum area and the medial foot region exhibited the lowest PPTs (indicative of high sensitivity). Notably, the foot dorsum area near the toes displayed the highest pain sensitivity (indicative of the lowest PPT), while the plantar area demonstrated comparatively lower pain sensitivity. The heel area exhibited the lowest pain sensitivity. Simultaneously, the study observed that women's feet exhibited lower pain thresholds than men's. In the future, it is imperative to delve deeper into the correlation between short-term pain sensitivity and the daily, long-term exercise state, as well as other physiological data. This exploration will contribute to a more nuanced guide for footwear comfort design.

Effectiveness of Dry Needling of the Tibialis Posterior for Control of the Medial Longitudinal Foot Arch

Effectiveness of Dry Needling of the Tibialis Posterior for Control of the Medial Longitudinal Foot Arch

Biomechanical gait analysis and rehabilitation in a traumatic hallux deficit patient: a case report

BackgroundThe hallux plays a crucial role in maintaining standing balance and facilitating forward and backward movements during gait.Case presentationA 21-year-old Japanese patient, suffering from a traumatic hallux deficit with only a portion of the basal phalanx intact, underwent rehabilitation treatment. The thenar area exhibited instability, leading to impaired balance and walking difficulties. Biomechanical assessment revealed the need for a rehabilitation strategy for the foot, as well as the knee, hip, and trunk. A rehabilitation protocol was designed to enhance medial foot loading during walking and standing, including balance and trunk strength training. After a 12-week rehabilitation period, the patient’s gait showed significant improvement. Specifically, the load response and single-support phases of the gait cycle on the affected side increased from 46.9% to 49.3%, while the pre-swing phase decreased from 14.6% to 11.6%. The vertical component of the ground reaction force rose from 599.8 to 647.5 N. The enhanced stability from balance training and increased muscle strength contributed to the patient’s improved walking and balance.ConclusionA patient with a traumatic hallux deficit underwent conservative treatment through strategic rehabilitation according to biomechanical assessment. This case report underscores the value of biomechanical gait analysis in the conservative management of similar conditions.

Biomechanical Effects of Subtalar Joint Fusion and Medial Ligament Reconstruction in Simulated Progressive Collapsing Foot Deformity.

The purpose of this study is to investigate the biomechanical effect of medial displacement calcaneal osteotomy (MDCO), subtalar joint fusion (SF), and medial ligament reconstruction (MLR: deltoid-spring ligament) in a severe flatfoot model. We hypothesized that (1) combination of MDCO and SF improves the tibiotalar and foot alignment in severe progressive collapsing foot deformity (PCFD) cadaver model. (2) However, if a residual valgus heel alignment remains after MCDO and SF, it can lead to increased medial ligament strain, foot malalignment, and tibiotalar valgus tilt, which will be mitigated by the addition of MLR. Ten fresh-frozen cadaveric foot specimens were used to create a severe flatfoot model. The foot alignment changes, including the talo-first metatarsal angle in the axial and sagittal planes, subtalar angle, and tibiotalar angle in the coronal plane, were measured. The angles were measured at the initial condition, after creating the severe flatfoot model, and after each successive reconstructive procedure in the following order: (1) MDCO, (2) SF, and (3) MLR. Tibiotalar valgus tilt was decreased with the MDCO procedure: 4.4 vs 1.0 degrees (P = .04). Adding in situ SF to the MDCO led to increased tibiotalar tilt to 2.5 degrees was different from the initial condition (P = .01). Although the tibiotalar valgus tilt was significantly decreased after adding the MLR to the MDCO/SF procedure compared with the severe flatfoot model (0.8 vs 4.4 degrees, P = .03), no significant difference in the tibiotalar valgus tilt was observed between MDCO/SF and MDCO/SF with MLR. Our results demonstrated that MDCO significantly improved forefoot abduction and medial arch alignment, with no significant additional improvement observed with addition of SF. Following SF, a residual valgus heel alignment can contribute to subsequent tibiotalar valgus tilt. The addition of MLR did not show significantly decreased tibiotalar valgus tilt following SF. Residual valgus heel alignment after subtalar joint fusion in the surgical treatment of PCFD can lead to increased medial ligament strain. Although MLR might be considered for providing medial stability, it may not necessarily prevent the development of tibiotalar valgus tilt.

A comparison of the effects of mediolateral surface and foot placement perturbations on balance control and response strategies during walking

BackgroundBalance perturbation studies during walking have improved our understanding of balance control in various destabilizing conditions. However, it is unknown to what extent balance recovery strategies can be generalized across different types of mediolateral balance perturbations. Research questionDo similar mediolateral perturbations (foot placement versus surface translation) have similar effects on balance control and corresponding balance response strategies? MethodsKinetic and kinematic data were previously collected during two separate studies, each with 15 young, healthy participants walking on an instrumented treadmill. In both studies, medial and lateral balance perturbations were applied at 80% of the gait cycle either by a treadmill surface translation or a pneumatic force applied to the swing foot. Differences in balance control (frontal plane whole body angular momentum) and balance response strategies (hip abduction moment, ankle inversion moment, center of pressure excursion and frontal plane trunk moment) between perturbed and unperturbed gait cycles were evaluated using statistical parametric mapping. ResultsBalance disruptions after foot placement perturbations were larger and sustained longer compared to surface translations. Changes in joint moment responses were also larger for the foot placement perturbations compared to the surface translation perturbations. Lateral hip, ankle, and trunk strategies were used to maintain balance after medial foot placement perturbations, while a trunk strategy was primarily used after surface translations. SignificanceSurface and foot placement perturbations influence balance control and corresponding response strategies differently. These results can help inform the development of perturbation-based balance training interventions aimed at reducing fall risk in clinical populations.

Correlation of Posterior Tibial Tendon Ultrasound with Calcaneal Inclination Angle in Indonesian Professional Athletes with Medial Ankle Pain.

Background: Adult-acquired flatfoot deformity (AAFD) is characterized by partial or complete flattening of the longitudinal medial arch, which develops after maturity. AAFD secondary to posterior tibialis tendon dysfunction (PTTD) is one of professional athletes' most common foot and ankle pathologies. Different modalities and procedures can be used to establish the diagnosis of AAFD and PTTD. However, imaging measurements such as the calcaneal inclination index and ultrasonography (US) of the posterior tibialis tendon (PTT) in professional athletes with medial ankle and focal pain along the PTT have yet to be widely studied. This study investigates the correlation of PTT ultrasound for evaluating PTTD with calcaneal inclination angle (CIA) for evaluating AAFD in professional athletes with medial ankle and focal pain along the PTT. Through this study, clinicians and radiologists may benefit from considering AAFD in athletes with PTTD. Methods: 112 Indonesian professional athletes with medial ankle or foot pain and focal pain along the direction of the PTT underwent foot radiography using the CIA and ankle ultrasound to observe PTT abnormalities. Results: A negative correlation between fluid thickness surrounding the PTT and the CIA (p<0.001; 95% CI - 0.945, - 0.885), as well as a negative correlation between PTT thickness and CIA (p<0.001, 95% CI - 0.926, - 0.845), with a correlation coefficient (r) of - 0.921 and - 0.892, respectively. No significant correlation was found between PTT tear and CIA (p = 0.728; 95% CI -0.223, - 0.159; r - 0.033). Conclusion: This study showed a negative correlation between PTTD and AAFD via ultrasound and CIA in professional athletes with medial ankle and focal pain along the PTT. A better understanding of PTTD and AAFD imaging will lead to more effective management and prompt treatment.

A Cross-Sectional Study on Fall Direction and Lower Limb Loading in Response to a Perturbation on Laterally Inclined Platform.

Perturbation-based balance training (PBT) improves reactive stepping in older adults and people with neurological disorders. Slip-induced falls are a threat to older adults, leading to hip fractures. Fall-prone individuals must be trained to regain balance during a fall in the posterolateral direction. This study aims to analyze the characteristics of the reactive step induced by a laterally inclined platform. This cross-sectional study included 46 healthy participants who performed a "lean and release" backward fall using a platform with two inclined angles on each side. Kinovea software was used to analyze the step width. Reactive steps, characterized by crossover or medial foot placement, are preventive measures against posterolateral falls. The first objective was on the narrowed step width that was subjected to analysis using analysis of variance (ANOVA) and Tukey's post hoc assessment, indicating a tendency toward posterolateral falls. As part of our second objective, the inclined platform resulted in uneven loading between the legs, with a preference for the unloaded leg as the reactive leg (p < 0.001), as determined by Fisher's exact test and Cramer's V. These characteristics align closely with those observed in modified constraint-induced movement therapy (mCIMT). The angled platform had a significant effect on selecting the reactive leg, particularly at higher angles (p < 0.001). Thus, the study suggested that the device is capable of inducing posterolateral falls and exhibited mCIMT characteristics.

Reverse Sural Artery Flap: Anatomic Study of Peroneal Perforators and Clinical Modifications for Coverage of Medial and Distal Foot Defects

Reverse Sural Artery Flap: Anatomic Study of Peroneal Perforators and Clinical Modifications for Coverage of Medial and Distal Foot Defects

Variation in Medial Foot Arch and Its Association with Different Categories of Body Mass Index- A Review

Background: Foot posture plays an important role in an individual’s life. The Body Mass Index (BMI) is believed to be one of the prominent factors in changing the function of foot arch. Methods: The keywords that were used were: osteoarthritis, OA knee, foot arch, medial arch, and foot posture. After finalizing keywords, internet search was conducted on Pub Med and Google Scholar; the University library and research center were also approached for e-copy and possible hand search of articles. The criteria for inclusion of articles were all research designs like Systematic review, Meta-analysis, Randomized Control trials, Cross sectional studies, Narrative Reviews and editor’s notes published in the English language, and full articles providing data on foot arches or foot posture in subjects with osteoarthritis of the knee. Results: In this review, total 12 articles were included from the various platforms and search engines. All the articles were appraised and scrutinized; their methodology, results and conclusion were read and filtered out. Conclusion: It was concluded that variation in foot arch has association with the different categories of BMI.

Autonomic function in sporadic and familial ALS type 8

ObjectiveTo characterize and compare autonomic function in patients with sporadic (sALS) and familial ALS type 8 (fALS8). MethodsWe selected 11 patients with sALS (7 men), 14 with fALS8 (8 men) and 26 controls (15 men). All groups were gender and age-matched. For each subject, Scale for Outcomes in Parkinson's Disease for Autonomic Symptoms (SCOPA-AUT) was applied and data from heart rate variability, Quantitative Sudomotor Axon Reflex Test (QSART) and skin sympathetic response (SSR) were collected. These data were compared across groups using nonparametric tests. P-values < 0.05 were considered significant. ResultsSCOPA-AUT revealed predominant clinical complaints in thermoregulatory, pupillomotor and sexual domains in fALS8 relative to sALS as well as controls. Neurophysiological tests demonstrated significant differences in Valsalva ratio, Expiratory:Inspiratory index and RR minimum values in both ALS groups relative to controls. Sudomotor dysfunction was also observed in sALS and fALS8 groups, as shown by reduced medial forearm and foot QSART volumes and absence of SSR in lower limbs. ConclusionsDysautonomia – cardiac and sudomotor - is part of the phenotype in sALS and fALS8. The profile of autonomic symptoms, however, is different in each group. SignificancePatients with fALS8 and sALS have autonomic dysfunction involving both sympathetic and parasympathetic divisions.

Regional plantar forces and surface geometry variations of a chronic ankle instability population described by statistical shape modelling

BackgroundUnderstanding detailed foot morphology as well as regional plantar forces could provide insight into foot function and provide recommendation for footwear design for chronic ankle instability (CAI) people. Research QuestionThis study presented 3-dimensional statistical shape models of feet from three different populations including CAI, copers and healthy individuals, with regional plantar forces also acquired. MethodsSixty-six males (22 participants per group) were included in this study to capture 3-dimensional foot shapes under a standing condition and regional plantar forces during a cutting maneuver. Principal component analysis was performed to generate a mean foot shape of each group as well as modes of variations. A generalized procrustes analysis was used to achieve rapid registration of mean shapes. Besides, regional plantar forces and contact duration among these three populations were compared. ResultsFor 3-dimensional foot shapes, although no significant differences of the average distance between each mode and mean shape were found among three populations, there were subtle variations in mean shapes. The CAI population presented a more bulging of the lateral malleolus; copers were characterized by the flexion of the lesser toes, a more bulging of the medial foot in the sagittal plane; and healthy individuals showed a greater heel width and a more bulging of the heel in the sagittal plane. In terms of plantar forces, healthy individuals had significantly greater summated plantar forces and greater plantar forces in the lateral heel area during the early contact phase compared to copers and CAI participants. SignificanceOverall, this study suggested that repetitive ankle sprains may lead to the bulging of the lateral malleolus. Further, CAI and copers seem to stabilize the ankle joint by medially shifting the center of pressure compared to healthy individuals under the static and less challenging dynamic conditions.

Effects of Foot Structure Type on Core Stability in University Athletes.

This study assessed the impact of different types of medial foot arch on postural stability and core center of gravity muscle activity among collegiate athletes. The study sample included 103 university-level athletes across various sports (soccer, rugby, basketball, volleyball, field tennis, table tennis, karate, and cheerleading) from the College of Magdalena (Colombia) who exhibited distinct types of medial foot arch: 32 high, 35 low, and 36 neutral arches. Surface electromyography (sEMG) was employed to assess conduction velocity, magnitude values, latency, and fatigue in focal muscles including the spinal erector (SE), internal oblique (IO), external oblique (EO), and rectus abdominis (AR), while measurements of static and dynamic postural control were also considered. Post hoc analysis was performed with Bonferroni correction for all electromyographically measured muscle groups, as well as for measurements of static and dynamic postural stability. Pearson's or Spearman's correlation tests were used to compare the different types of feet. There were no substantial differences observed between the distinct types of feet in terms of focal muscle activity, static stability, or dynamics. Even though the mean values indicated higher muscle activity and stability among those with high foot arches and lower values among those with low arches compared to the neutral foot type, this observed difference was deemed statistically insignificant. We also observed a positive correlation between internal oblique muscle activity and the average power of dynamic postural stability, which remained consistent across all foot types. Our findings indicate that static instability is directly correlated with dynamic instability in the anteroposterior direction, while a clear inverse relationship was established in the lateral direction upon examining the variable correlations. The presence of high or low foot arches did not significantly impact the activity of the muscles responsible for maintaining the body's center of gravity or postural stability among university-level athletes. This suggests the existence of neuromuscular compensation mechanisms that attempt to restore balance and compensate for any changes in postural stability caused by varying foot types. Through targeted training that emphasizes activation of the internal oblique muscle, athletes may see improved postural stability. Our findings indicate that static stabilization exercises can also prove beneficial in improving dynamic stability in the anteroposterior plane, while a more dynamic approach may be required to improve dynamic stability in the lateral plane.

Effects of Rearfoot Eversion on Foot Plantar Pressure and Spatiotemporal Gait Parameters in Adolescent Athletes

Background: Foot malalignment can augment the risk of lower-extremity injuries and lead to musculoskeletal disorders. This study aimed to clarify the contribution of rearfoot alignment to plantar pressure distribution and spatiotemporal parameters during gait in healthy adolescent athletes. Methods: This retrospective study included 39 adolescent athletes who were divided into the rearfoot eversion and control groups according to a leg heel angle of 7°. A total of 78 legs were analyzed (45 and 33 legs in the rearfoot eversion [women, 53.3%] and control groups [women, 48.5%], respectively). Gait was assessed using an in-shoe plantar pressure measuring system and a wearable inertial sensor. Results: The foot plantar pressure distribution in the hallux was higher in the rearfoot eversion group than that in the control group (p = 0.034). Spatiotemporal parameters showed that the foot pitch angle at heel strike was significantly larger in the rearfoot eversion group than that in the control group (24.5° vs. 21.7°; p = 0.015). Total sagittal range of motion of the ankle during the stance phase of gait was significantly larger in the rearfoot eversion group than that in the control group (102.5 ± 7.1° vs. 95.6 ± 15.8°; p = 0.020). Logistic regression analysis revealed that plantar pressure at the hallux and medial heel and foot pitch angle at heel strike were significantly associated with rearfoot eversion. Conclusions: Our findings suggest that rearfoot eversion affects the gait patterns of adolescent athletes. Notably, leg heel angle assessment, which is a simple and quick procedure, should be considered as an alternative screening tool for estimating plantar pressure and spatiotemporal gait parameters to prevent sports-related and overuse injuries in adolescent athletes.

Is Kidner procedure necessary during subtalar arthroereisis for pediatric flexible flatfoot that combined with symptomatic type 2 accessory navicular? A retrospective comparative study

BackgroundKidner procedure is thought to be able to eliminate the medial foot pain and contribute to restoring the medial longitudinal foot arch, making it particularly suitable for surgical treatment of pes planus that combined with symptomatic type 2 accessory navicular (AN). However, controversy remains, and the clinical evidence is still lacking. The aim of the current study is to verify the necessity of Kidner procedure during subtalar arthroereisis (STA) for pediatric flexible flatfoot (PFF) that combined with symptomatic type 2 AN. MethodsForty pediatric patients (72 feet) who had undergone STA for flexible flatfoot and were also diagnosed with symptomatic type 2 AN concomitantly were reviewed retrospectively and divided into two groups (STA + Kidner vs STA alone). The visual analog scale (VAS), the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale, the Oxford ankle foot questionnaire for children (OAFQC), and the radiographic parameters that quantifying pes planus were evaluated as primary outcomes. Secondary outcomes included the incidence of complications. ResultsThere were 35 feet in the STA + Kidner group and 37 feet in the STA alone group, with mean follow-up periods of 2.7 years and 2.1 years, respectively. The VAS, AOFAS, OAFQC scores and radiographic parameters presented no significant difference between the two groups both preoperatively and at final follow-up (P > 0.05 for each). The complications of STA surgery occurred equally in both groups, and Kidner procedure could lead to more incision problems (22.9% vs. 2.7%) and a longer time to return to activity. ConclusionKidner procedure may be unnecessary during surgical treatment of PFF that combined with painful type 2 AN. Correcting the PFF while leaving the AN alone has a high possibility of relieving the pain in the AN region, and tibialis posterior tendon (TPT) rerouting hardly aids in reconstruction of the medial foot arch. Level of EvidenceIII.

The effect of orthotics on plantar pressure in children with infantile tibia vara (Blount's disease)

Albeit some studies have revealed the effectiveness of the orthosis use in infantile tibia vara (ITV), hitherto no study has shown the effects of these orthosis on plantar pressures. This study aims to reveals the effects of orthosis on plantar pressure in infantile tibia vara. Fourteen children (mean age: 27.14 ± 5.00 months) with infantile tibia vara made up the study group and 14 healthy children (mean age: 26.42 ± 5.33 months) constituted the control group. The plantar pressure distribution was evaluated with WALKINSENSE. ITV group was evaluated before and after orthosis. The control group did not use orthosis and was evaluated once. After orthosis, it was determined that lateral foot pressure decreased, and medial foot pressure increased in the hindfoot. After orthosis, medial pressure decreased in the forefoot (p < 0.05). The pressure in the forefoot of the control group was significantly higher than that in the ITV group (before and after orthosis) (p < 0.05). After orthosis, the pressure was similar in the posterior and mid-foot sensors between the ITV group and the control group (p˃0.05). The orthosis can be effective in achieving the normalization of the soles pressure distribution in children with ITV.

The change in medial and lateral foot loading during different squat variations – an explorative pilot study

The change in medial and lateral foot loading during different squat variations – an explorative pilot study