Discrepancy between true ankle dorsiflexion and gait kinematics and its association with severity of planovalgus foot deformity
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...
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doaj-5d0ac770affb43678459c4090fa876422020-11-25T03:16:36ZengBMCBMC Musculoskeletal Disorders1471-24742020-04-012111810.1186/s12891-020-03285-3Discrepancy between true ankle dorsiflexion and gait kinematics and its association with severity of planovalgus foot deformityKi Hyuk Sung0Chin Youb Chung1Kyoung Min Lee2Ki Bum Kwon3Jeong Hyun Lee4Moon Seok Park5Department of Orthopaedic Surgery, Seoul National University Bundang HospitalDepartment of Orthopaedic Surgery, Seoul National University Bundang HospitalDepartment of Orthopaedic Surgery, Seoul National University Bundang HospitalDepartment of Orthopaedic Surgery, Seoul National University Bundang HospitalDepartment of Orthopaedic Surgery, Seoul National University Bundang HospitalDepartment of Orthopaedic Surgery, Seoul National University Bundang HospitalAbstract 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.http://link.springer.com/article/10.1186/s12891-020-03285-3PlanovalgusAnkle dorsiflexionPhysical examination3-dimensional gait analysis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ki Hyuk Sung Chin Youb Chung Kyoung Min Lee Ki Bum Kwon Jeong Hyun Lee Moon Seok Park |
spellingShingle |
Ki Hyuk Sung Chin Youb Chung Kyoung Min Lee Ki Bum Kwon Jeong Hyun Lee Moon Seok Park Discrepancy between true ankle dorsiflexion and gait kinematics and its association with severity of planovalgus foot deformity BMC Musculoskeletal Disorders Planovalgus Ankle dorsiflexion Physical examination 3-dimensional gait analysis |
author_facet |
Ki Hyuk Sung Chin Youb Chung Kyoung Min Lee Ki Bum Kwon Jeong Hyun Lee Moon Seok Park |
author_sort |
Ki Hyuk Sung |
title |
Discrepancy between true ankle dorsiflexion and gait kinematics and its association with severity of planovalgus foot deformity |
title_short |
Discrepancy between true ankle dorsiflexion and gait kinematics and its association with severity of planovalgus foot deformity |
title_full |
Discrepancy between true ankle dorsiflexion and gait kinematics and its association with severity of planovalgus foot deformity |
title_fullStr |
Discrepancy between true ankle dorsiflexion and gait kinematics and its association with severity of planovalgus foot deformity |
title_full_unstemmed |
Discrepancy between true ankle dorsiflexion and gait kinematics and its association with severity of planovalgus foot deformity |
title_sort |
discrepancy between true ankle dorsiflexion and gait kinematics and its association with severity of planovalgus foot deformity |
publisher |
BMC |
series |
BMC Musculoskeletal Disorders |
issn |
1471-2474 |
publishDate |
2020-04-01 |
description |
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. |
topic |
Planovalgus Ankle dorsiflexion Physical examination 3-dimensional gait analysis |
url |
http://link.springer.com/article/10.1186/s12891-020-03285-3 |
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