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Discrepancy between true ankle dorsiflexion and gait kinematics and its association with severity of planovalgus foot deformity.
BMC Musculoskelet Disord. 2020 Apr 16; 21(1):250.BM

Abstract

BACKGROUND

In planovalgus deformity with triceps contracture, a midfoot break happens, and ankle dorsiflexion (ADF) occurs at the mid-tarsal joint during gait. Results of standard 3D gait analysis may misinterpret the true ankle dorsiflexion because it recognizes the entire foot as a single rigid segment. We performed this study to investigate whether the severity of planovalgus deformity is associated with the discrepancy between the value of ADF evaluated by physical examination and 3-dimensional (3D) gait analysis. In addition, we aimed to identify the radiographic parameters associated with this discrepancy and their relationships.

METHODS

Consecutive 40 patients with 65 limbs (mean age, 11.7 ± 5.5 years) with planovalgus foot deformity and triceps surae contracture were included. All patients underwent 3D gait analysis, and weightbearing anteroposterior (AP) and lateral (LAT) foot radiographs. ADF with knee extension was measured using a goniometer with the patient's foot in an inverted position.

RESULTS

Twenty-one limbs underwent operation for planovalgus foot deformity, and 56 limbs underwent operation for equinus deformity. The difference between ADF on physical examination and ADF at initial contact on gait analysis was 17.5 ± 8.4°. Differences between ADF on physical examination and ADF at initial contact on gait analysis were significantly associated with the LAT talus-first metatarsal angle (p = 0.008) and calcaneal pitch angle (p = 0.006), but not associated with the AP talus-first metatarsal angle (p = 0.113), talonavicular coverage angle (p = 0.190), talocalcaneal angle (p = 0.946), and naviculocuboid overlap (p = 0.136).

CONCLUSION

The discrepancy between ADF on physical examination and 3D gait analysis was associated with the severity of planovalgus deformity, which was evaluated on weightbearing LAT foot radiographs. Therefore, physicians should be cautious about interpreting results from 3D gait analysis and perform a careful physical examination to assess the degree of equinus deformity in patients with planovalgus foot deformity.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-Gu, Sungnam, Gyeonggi, 13620, South Korea.Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-Gu, Sungnam, Gyeonggi, 13620, South Korea.Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-Gu, Sungnam, Gyeonggi, 13620, South Korea.Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-Gu, Sungnam, Gyeonggi, 13620, South Korea.Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-Gu, Sungnam, Gyeonggi, 13620, South Korea.Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-Gu, Sungnam, Gyeonggi, 13620, South Korea. pmsmed@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32299475

Citation

Sung, Ki Hyuk, et al. "Discrepancy Between True Ankle Dorsiflexion and Gait Kinematics and Its Association With Severity of Planovalgus Foot Deformity." BMC Musculoskeletal Disorders, vol. 21, no. 1, 2020, p. 250.
Sung KH, Chung CY, Lee KM, et al. Discrepancy between true ankle dorsiflexion and gait kinematics and its association with severity of planovalgus foot deformity. BMC Musculoskelet Disord. 2020;21(1):250.
Sung, K. H., Chung, C. Y., Lee, K. M., Kwon, K. B., Lee, J. H., & Park, M. S. (2020). Discrepancy between true ankle dorsiflexion and gait kinematics and its association with severity of planovalgus foot deformity. BMC Musculoskeletal Disorders, 21(1), 250. https://doi.org/10.1186/s12891-020-03285-3
Sung KH, et al. Discrepancy Between True Ankle Dorsiflexion and Gait Kinematics and Its Association With Severity of Planovalgus Foot Deformity. BMC Musculoskelet Disord. 2020 Apr 16;21(1):250. PubMed PMID: 32299475.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Discrepancy between true ankle dorsiflexion and gait kinematics and its association with severity of planovalgus foot deformity. AU - Sung,Ki Hyuk, AU - Chung,Chin Youb, AU - Lee,Kyoung Min, AU - Kwon,Ki Bum, AU - Lee,Jeong Hyun, AU - Park,Moon Seok, Y1 - 2020/04/16/ PY - 2019/11/14/received PY - 2020/04/13/accepted PY - 2020/4/18/entrez PY - 2020/4/18/pubmed PY - 2020/4/18/medline KW - 3-dimensional gait analysis KW - Ankle dorsiflexion KW - Physical examination KW - Planovalgus SP - 250 EP - 250 JF - BMC musculoskeletal disorders JO - BMC Musculoskelet Disord VL - 21 IS - 1 N2 - BACKGROUND: In planovalgus deformity with triceps contracture, a midfoot break happens, and ankle dorsiflexion (ADF) occurs at the mid-tarsal joint during gait. Results of standard 3D gait analysis may misinterpret the true ankle dorsiflexion because it recognizes the entire foot as a single rigid segment. We performed this study to investigate whether the severity of planovalgus deformity is associated with the discrepancy between the value of ADF evaluated by physical examination and 3-dimensional (3D) gait analysis. In addition, we aimed to identify the radiographic parameters associated with this discrepancy and their relationships. METHODS: Consecutive 40 patients with 65 limbs (mean age, 11.7 ± 5.5 years) with planovalgus foot deformity and triceps surae contracture were included. All patients underwent 3D gait analysis, and weightbearing anteroposterior (AP) and lateral (LAT) foot radiographs. ADF with knee extension was measured using a goniometer with the patient's foot in an inverted position. RESULTS: Twenty-one limbs underwent operation for planovalgus foot deformity, and 56 limbs underwent operation for equinus deformity. The difference between ADF on physical examination and ADF at initial contact on gait analysis was 17.5 ± 8.4°. Differences between ADF on physical examination and ADF at initial contact on gait analysis were significantly associated with the LAT talus-first metatarsal angle (p = 0.008) and calcaneal pitch angle (p = 0.006), but not associated with the AP talus-first metatarsal angle (p = 0.113), talonavicular coverage angle (p = 0.190), talocalcaneal angle (p = 0.946), and naviculocuboid overlap (p = 0.136). CONCLUSION: The discrepancy between ADF on physical examination and 3D gait analysis was associated with the severity of planovalgus deformity, which was evaluated on weightbearing LAT foot radiographs. Therefore, physicians should be cautious about interpreting results from 3D gait analysis and perform a careful physical examination to assess the degree of equinus deformity in patients with planovalgus foot deformity. SN - 1471-2474 UR - https://www.unboundmedicine.com/medline/citation/32299475/Discrepancy_between_true_ankle_dorsiflexion_and_gait_kinematics_and_its_association_with_severity_of_planovalgus_foot_deformity L2 - https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-020-03285-3 DB - PRIME DP - Unbound Medicine ER -
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