Kinematic differences in the presentation of recurrent congenital talipes equinovarus (clubfoot).

Biomechanical Phenomena Clubfoot / diagnosis Foot Humans Tendon Transfer / methods Treatment Outcome
Clubfoot Foot model Plantar pressure Tibialis anterior tendon transfer

Journal

Gait & posture
ISSN: 1879-2219
Titre abrégé: Gait Posture
Pays: England
ID NLM: 9416830

Informations de publication

Date de publication:
07 2022
Historique:
received: 22 06 2021
revised: 03 05 2022
accepted: 12 05 2022
pubmed: 14 6 2022
medline: 3 8 2022
entrez: 13 6 2022
Statut: ppublish

Résumé

The tibialis anterior tendon transfer (TATT) is the suggested surgical intervention in the Ponseti method for treatment of dynamic recurrent congenital talipes equinovarus (clubfoot) presenting as hindfoot varus and forefoot supination during the swing phase of gait. The indication for surgery, however, is typically based on visual assessment, which does not sufficiently examine the variability of foot motion in this cohort. The aim of this research was to determine whether subgroups, based on foot model kinematics, existed within a clubfoot cohort being considered for TATT surgery. Sixteen children with recurrent clubfoot that had been previously treated with the Ponseti method and were being considered for tendon transfer surgery were prospectively recruited for this study and were required to attend a pre-surgery data collection session at the Queensland Children's Motion Analysis Service (QCMAS). Data collected included standard Plug-in-Gait (PiG) kinematics and kinetics, Oxford Foot Model (OFM) foot kinematics, and regional plantar loads based on anatomical masking using the integrated kinematic-pressure method. Results of this study identified two clear subgroups within the cohort. One group presented with increased hindfoot inversion across 91 % of the gait cycle. The second group presented with increased hindfoot adduction across 100 % of the gait cycle. Hindfoot adduction was statistically significantly different between the two groups. The identification of these two groups propose a need for further classification of deformity within this cohort and query the appropriateness of this surgical intervention for both presentations.

Sections du résumé

BACKGROUND
The tibialis anterior tendon transfer (TATT) is the suggested surgical intervention in the Ponseti method for treatment of dynamic recurrent congenital talipes equinovarus (clubfoot) presenting as hindfoot varus and forefoot supination during the swing phase of gait. The indication for surgery, however, is typically based on visual assessment, which does not sufficiently examine the variability of foot motion in this cohort.
RESEARCH QUESTION
The aim of this research was to determine whether subgroups, based on foot model kinematics, existed within a clubfoot cohort being considered for TATT surgery.
METHODS
Sixteen children with recurrent clubfoot that had been previously treated with the Ponseti method and were being considered for tendon transfer surgery were prospectively recruited for this study and were required to attend a pre-surgery data collection session at the Queensland Children's Motion Analysis Service (QCMAS). Data collected included standard Plug-in-Gait (PiG) kinematics and kinetics, Oxford Foot Model (OFM) foot kinematics, and regional plantar loads based on anatomical masking using the integrated kinematic-pressure method.
RESULTS
Results of this study identified two clear subgroups within the cohort. One group presented with increased hindfoot inversion across 91 % of the gait cycle. The second group presented with increased hindfoot adduction across 100 % of the gait cycle. Hindfoot adduction was statistically significantly different between the two groups.
SIGNIFICANCE
The identification of these two groups propose a need for further classification of deformity within this cohort and query the appropriateness of this surgical intervention for both presentations.

Identifiants

DOI: 10.1016/j.gaitpost.2022.05.016 PMID: 35696825
pubmed: 35696825
pii: S0966-6362(22)00147-3
doi: 10.1016/j.gaitpost.2022.05.016
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

195-202

Informations de copyright

Copyright © 2022 Elsevier B.V. All rights reserved.

Auteurs

Alexis Brierty (A)

Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4222, Australia; Queensland Children's Motion Analysis Service, Department of Orthopaedic Surgery Queensland Children's Hospital, Brisbane, QLD 4101, Australia. Electronic address: alexis.brierty@griffithuni.edu.au.

Sean Horan (S)

School of Allied Health Sciences, Griffith University, Gold Coast, QLD 4222, Australia.

Claudia Giacomozzi (C)

Italian National Institute of Health (Istituto Superiore di Sanità), Viale Regina Elena, 299, 00161 Roma, RM, Italy.

Liam Johnson (L)

Queensland Children's Motion Analysis Service, Department of Orthopaedic Surgery Queensland Children's Hospital, Brisbane, QLD 4101, Australia.

David Bade (D)

Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4222, Australia; Queensland Children's Motion Analysis Service, Department of Orthopaedic Surgery Queensland Children's Hospital, Brisbane, QLD 4101, Australia.

Christopher P Carty (CP)

Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4222, Australia; Queensland Children's Motion Analysis Service, Department of Orthopaedic Surgery Queensland Children's Hospital, Brisbane, QLD 4101, Australia; Research Development Unit, Caboolture and Kilcoy Hospitals, Metro North Health, Caboolture, QLD 4510, Australia.

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Classifications MeSH

questionsmedicales.fr › Phénomènes physiques › Phénomènes mécaniques › Phénomènes biomécaniques › Kinematic differences in the presentation of...
questionsmedicales.fr › Malformations et maladies congénitales, héréditaires et néonatales › Malformations › Malformations de l'appareil locomoteur › Anomalies morphologiques congénitales des membres › Anomalies morphologiques congénitales du membre inférieur › Anomalies morphologiques congénitales du pied › Pied bot › Pied bot varus équin congénital › Kinematic differences in the presentation of...
questionsmedicales.fr › Régions du corps › Membres › Membre inférieur › Pied › Kinematic differences in the presentation of...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Kinematic differences in the presentation of...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures orthopédiques › Transposition tendineuse › Kinematic differences in the presentation of...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Kinematic differences in the presentation of...