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1.
Rev. venez. cir. ortop. traumatol ; 53(1): 20-26, jun. 2021. ilus
Article in Spanish | LILACS, LIVECS | ID: biblio-1252895

ABSTRACT

Cuando fracasa el tratamiento conservador en el Estadio I de Disfunción del Tendón Tibial posterior (DTTP), se debe indicar sinovectomía y debridamiento del tendón. En este estudio evaluamos la evolución con 8 años mínimo de seguimiento, de los pacientes con esta patología tratados vía tenoscópica. Este es un estudio retrospectivo de pacientes operados entre el año 2008 y el año 2011. En ese período de tiempo se intervinieron 11 pacientes con esta patología. Sólo 9 de los 11 pacientes operados pudieron ser evaluados. 7 pacientes mejoraron su sintomatología según el VAS y no progresaron a estadio II. En 3 pacientes se evidenció lesión tendinosa durante la tendoscopía y ameritaron reparación a cielo abierto. La sinovectomía tendoscópica del TTP es un procedimiento quirúrgico efectivo para tratar a los pacientes con DTTP Estadio I, rebeldes a tratamiento conservador(AU)


When conservative treatment fails for Stage I Posterior Tibial tendon dysfunction (PTTD), synovectomy and tendon debridement is indicated. In this study we evaluate tendoscopic treatment results for this pathology with a minimum of 8 years follow up. This is a retrospective study of patients after tendoscopic surgery performed between 2008 and 2011. 9 of the 11 patients were available for evaluation. 7 improved their symptoms according to VAS scale, and did not progress to stage II. In 3 patients tendon tear was visualized during tendoscopy and needed open repair. PTT tendoscopy is an effective surgical treatment to treat Stage I PTTD, failing to conservative treatment(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Flatfoot , Magnetic Resonance Spectroscopy , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Posterior Tibial Tendon Dysfunction/pathology , Tendinopathy , Synovectomy , Ultrasonics , Cryotherapy , Diagnostic Techniques and Procedures , Debridement
3.
Acta ortop. mex ; 33(5): 289-291, sep.-oct. 2019. tab
Article in Spanish | LILACS | ID: biblio-1284958

ABSTRACT

Resumen: Introducción: Las alteraciones de la huella plantar en el niño es causa de preocupación en los padres de familia. Objetivo: Determinar la frecuencia de alteraciones de la huella plantar en escolares. Determinar si existe relación entre el sobrepeso y la obesidad con la presencia de alteraciones de la huella plantar. Material y métodos: Estudio observacional, transversal y prospectivo. Se evaluaron 959 escolares de seis a 13 años de edad. Se registró peso, talla, índice de masa corporal para la edad. La huella plantar se catalogó en pie plano y pie cavo utilizando el índice del arco. Para el análisis y comparación estadística se utilizó el programa SPSS versión 24 con las pruebas χ2 y ANOVA. Resultados: Se revisaron 530 niños (55.3%) y 429 niñas (44.7%). La media de edad fue de 8.97 años. Se observaron 182 niños (19%) con alteración de la huella plantar, 42.3% con pie plano y 57.7% con pie cavo. Ninguno mostró sintomatología del pie. Ciento treinta y un niños tenían sobrepeso y 52 obesidad, sin influir en la presencia de alguna alteración de la huella plantar (p = 0.20). La relación de pie plano fue mayor en los hombres (2.5:1) y de pie cavo fue mayor en las mujeres (1.3:1). Conclusiones: En nuestro grupo de estudio se encontró mayor prevalencia del pie cavo en comparación con el pie plano. El peso corporal no influyó en las alteraciones de la huella plantar.


Abstract: Introduction: Alterations in the plantar footprint in the child are a cause for concern in parents. Objective: Determine the frequency of plantar footprint alterations in school children. Determine if there is a relationship between overweight and obesity with the presence of alterations of the plantar footprint. Material and methods: Observational, transversal and prospective study. 959 schoolchildren aged six to 13 were evaluated. Weight, size, body mass index for age were recorded. The plantar footprint was cataloged on flat foot and cavus foot using the arch index. For statistical analysis and comparison, the SPSS version 24 program was used with the χ2 and ANOVA tests. Results: 530 children (55.3%) and 429 girls (44.7%). The median age was 8.97 years. 182 children were found (19%) with alteration of the plantar footprint, 42.3% with flat foot and 57.7% with cavus foot. None of them had foot symptoms. 131 children were overweight and 52 obese, without influencing the presence of any alteration of the plantar footprint (p = 0.20). The flat-foot ratio was higher in men (2.5:1) and standing cavus major in women (1.3:1). Conclusions: In our study group we find a higher prevalence of the cavus foot compared to the flat foot. Body weight did not influence plantar footprint alterations.


Subject(s)
Humans , Male , Female , Child , Body Weight , Flatfoot , Body Mass Index , Prospective Studies , Foot , Mexico
4.
Rev. Assoc. Med. Bras. (1992) ; 65(8): 1061-1066, Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1041062

ABSTRACT

SUMMARY OBJECTIVE The aim of this study was to determine the potential association of foot pain and plasmatic adipocytes as physiological biomarkers of childhood obesity with the incidence of flatfoot in a cohort of Egyptian school children aged 6 -12 years. METHODS A total of 550 Egyptian schoolchildren (220 boys and 330 girls) aged 6-12 years were randomly invited to participate in this descriptive survey analysis. For all children, we assessed the diagnosis and severity of flatfoot as well as plasma adipocytes, as well as adiponectin, leptin, resistin, IL-6, and TNF-α, using the Dennis method and immunoassay techniques respectively. Foot pain was assessed by using a standard VAS of 100 mm and Faces Pain Scale, respectively. RESULTS Flat foot was predicted in 30.4% of school-age children, most of them showed a higher frequency of overweight (33.3%) and obesity (62.5%). Boys showed higher ranges of flat foot than girls. Foot pain significantly correlated with flat foot and obesity among the studied populations. In overweight-obese children, plasmatic adipocyte variables, as well as adiponectin, leptin, resistin, IL-6, TNF-α.; showed significant correlations with foot stance, especially in boys. Also, the studied adipocyte variables along with BMI, age, gender explained about~65% of the variance of flatfoot with pain among our school-age students. CONCLUSION Foot pain showed an association with flat foot and childhood obesity in 30.4% of school-age students (6-12 years). Foot pain was shown to correlate positively with the incidence of flat foot and changes in adiposity markers, as well as adiponectin, leptin, resistin, Il-6, TNF-α


RESUMO OBJETIVO O objetivo deste estudo foi determinar a potencial associação de dor no pé e adipócitos plasmáticos como biomarcadores fisiológicos da obesidade infantil com incidência de pé plano em uma coorte de escolares egípcios de 6 a 12 anos. MÉTODOS Um total de 550 escolares egípcios (220 meninos e 330 meninas) com idades entre 6 e 12 anos foram convidados aleatoriamente para participar desta análise descritiva. Para todas as crianças, diagnóstico e gravidade do flatfoot, bem como adipócitos plasmáticos; adiponectina, leptina, resistina, IL-6 e TNF-α; foram avaliados pelo método de Dennis e técnicas de imunoensaio, respectivamente. A dor no pé foi avaliada usando uma EVA padrão de 100 mm e a Faces Pain Scale, respectivamente. RESULTADOS O pé plano foi predito em 30,4% das crianças em idade escolar; a maioria apresentou maior frequência de sobrepeso (33,3%) e obesidade (62,5%). Os meninos apresentaram maiores faixas de pé plano do que as meninas. A dor no pé correlacionou-se significativamente com pé plano e obesidade entre as populações estudadas. Em crianças obesas com sobrepeso, variáveis adipocitárias plasmáticas; adiponectina, leptina, resistina, IL-6 e TNF-α; apresentaram correlação significativa com a postura do pé, em meninos e meninas. Além disso, as variáveis estudadas dos adipócitos, juntamente com o IMC, idade e sexo, explicaram cerca de 65% da variância do pé plano com a dor entre os nossos alunos em idade escolar. CONCLUSÃO A dor no pé mostrou associação com pé plano e obesidade infantil em 30,4% dos estudantes em idade escolar (6-12 anos). A dor no pé se correlacionou positivamente com a incidência de pé plano e a mudança nos marcadores de adiposidade; adiponectina, leptina, resistina, IL-6, TNF-α.


Subject(s)
Humans , Male , Female , Child , Aged, 80 and over , Pain/blood , Flatfoot/blood , Biomarkers/blood , Adipocytes/chemistry , Obesity/blood , Pain/etiology , Severity of Illness Index , Pain Measurement , Enzyme-Linked Immunosorbent Assay , Flatfoot/complications , Body Mass Index , Cross-Sectional Studies , Cohort Studies , Interleukin-6/blood , Tumor Necrosis Factor-alpha/blood , Leptin/blood , Adiponectin/blood , Resistin/blood , Obesity/complications
5.
Rev. Eugenio Espejo ; 13(1): 45-52, Ene-Jul. 2019.
Article in Spanish | LILACS | ID: biblio-1006780

ABSTRACT

La forma en que se manejan los problemas biomecánicos en niños constituye un tema contro-versial en el campo de la rehabilitación física. Se desarrolló un proceso investigativo con el objetivo de: describir la evolución de un grupo de pacientes pediátricos mayores de dos años diagnosticados con pie plano atendidos en consulta de fisioterapia en la ciudad de Riobamba; la que fue de tipo observacional descriptivo, de corte longitudinal, cuya población de estudio estuvo constituida por las fichas de control, evaluación y valoración de 30 niños mayores de 2 años que acudieron a consulta de fisioterapia acompañados de un tutor legal por presentar signos de alteraciones de la huella plantar (pie plano). Se observó un predominio de los pacien-tes con edades comprendidas entre cuatro y cinco años, para un 33 y 27% respectivamente. El 93% de los participantes presentó alteraciones de la huella plantar comprobada mediante medi-ción utilizando el plantígrafo, pero el 53% tuvo pie plano fisiológico. Luego de aplicados los ejercicios de Risser, los datos reflejaron una elevación de la cifra de huella plantar normal hasta el 33% y una disminución en el grado de afectación en el 35% de los niños diagnosticados. Los resultados de la recuperación fueron ratificados mediante el análisis del desgaste del calzado en los pacientes pediátricos en cuestión.


The way how biomechanical problems are handled is a controversial topic in the field of physi-cal rehabilitation. This is a research was carried out in order to describe the evolution of a group of pediatric patients over two years of age diagnosed with flat feet treated in a physiotherapy consultation in the city of Riobamba. This research was of observational descriptive type and longitudinal-cut. The study population consisted of the control, evaluation and assessment cards of 30 children over 2 years of age who attended a physiotherapy consultation accompanied by a legal guardian to show signs of alterations in the footprint (flat foot). A predominance of patients between four and five years of age with 33% and 27% respectively was observed. 93% of the participants presented alterations of the footprint checked by the means of a machine for measu-ring foot plant, but 53% had physiological flat feet. After applying the Risser exercises, the data was reflected in the figure of normal footprint up to 33%, and a decrease of affectation in 35% of the children diagnosed. The results of the recovery were confirmed through the analysis of footwear wear in the pediatric patients in question.


Subject(s)
Male , Female , Child, Preschool , Foot Deformities , Flatfoot , Musculoskeletal Diseases , Orthopedics , Physical and Rehabilitation Medicine , Child
6.
Fisioter. Bras ; 20(3): 340-347, Junho 11, 2019.
Article in Portuguese | LILACS | ID: biblio-1281250

ABSTRACT

Introdução: O equilíbrio é essencial para o desempenho das atividades cotidianas e funcionalidade. É dependente da interação entre sistemas visual, vestibular e periférico, dos comandos do sistema nervoso central e respostas neuromusculares. Objetivo: Verificar a relação do estado nutricional e padrão de arco longitudinal medial (ALM) de pés com o equilíbrio de crianças entre 4 e 5 anos de idade. Métodos: Foram avaliadas 16 crianças, realizando avaliações antropométricas e análise do estado nutricional; depois, avaliação do ALM, com utilização de pedígrafo e classificação pelo índice de Cavanagh e Rodgers; por fim, avaliação do equilíbrio pela Escala de Equilíbrio Pediátrica (EEP). Resultados: O escore médio dos participantes na EEP foi de 53,56, variando entre 50 e 56. Com relação ao estado nutricional, 6,25% apresentaram obesidade, 18,75% risco de sobrepeso e o restante apresentou eutrofia. Para a análise do ALM constatou-se que 62,5% dos participantes apresentaram pé plano, 25% pé normal e 12,5% pé cavo. Conclusão: O estudo aponta que o sexo masculino, seguido da presença de pé plano, apresentou maior relação com o déficit de equilíbrio para a população de 4 a 5 anos. Já as crianças com sobrepeso e obesidade obtiveram escores típicos na EEP, retratando a necessidade de mais estudos. (AU)


Introduction: Balance is essential for the performance of everyday activities and functionality. It is dependent on the interaction between visual, vestibular and peripheral systems, central nervous system commands and neuromuscular responses. Objective: To relate the nutritional status and pattern of the medial longitudinal arch (MLA) of the feet with the balance of children between 4 and 5 years of age. Methods: We evaluated 16 children, performing anthropometric assessments and analysis of nutritional status; then MLA evaluation, using pedigree and classification by the Cavanagh and Rodgers index; finally, evaluation of balance by the Pediatric Balance Scale (PBS). Results: The mean score of the participants in the PBS was 53.56, ranging from 50 to 56. Regarding nutritional status, 6.25% presented obesity, 18.75% risk of overweight and the other presented eutrophy. For MLA analysis, 62.5% of the participants had flat feet, 25% normal feet and 12.5% foot caves. Conclusion: The study indicates that the male sex, followed by the presence of flat feet, presented a greater relation with the deficit of balance for the population of 4 to 5 years. On the other hand, overweight and obese children had typical scores on PBS, showing the need for further studies. (AU)


Subject(s)
Humans , Male , Female , Child, Preschool , Flatfoot , Nutritional Status , Postural Balance , Activities of Daily Living , Child , Talipes Cavus
7.
Rev. bras. ortop ; 54(3): 275-281, May-June 2019. tab, graf
Article in English | LILACS | ID: biblio-1013732

ABSTRACT

Abstract Objective The present study aims to evaluate the ability of triple arthrodesis in eliminating the main complaints presented by patients with adult acquired flatfoot deformity (AAFD): 1) disabling hindfoot pain; 2) major deformities, such asmedial arch collapse, valgus, abduction, and supination. Methods A total of 17 patients (20 feet) with advanced AAFD who underwent surgical correction by triple arthrodesis were evaluated after a mean follow-up period of 43 months (range: 18-84 months). The average age of the patients at surgery was 62 years old (range: 38-79 years old). The visual analogue scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score were used to assess the final results. Results According to the VAS, the average residual pain was 3 points; the AOFAS hindfoot score points increased 23% after the surgery; and the correction of deformities was considered satisfactory in 10 out of 20 feet; partially satisfactory in 4 out of 20 feet; partially unsatisfactory in 5 out of 20 feet; and unsatisfactory in 1 out of 20 feet. Conclusion Despite the high index of bone fusion after triple arthrodesis, which is the gold standard treatment in advanced AAFD, the incomplete correction of major deformities and the persistence of residual pain contributed to a high disappointment rate of the patients with the surgical results.


Resumo Objetivo Avaliar a capacidade da artrodese tríplice de aliviar as principais queixas dos pacientes que apresentam pé plano adquirido do adulto (PPAA): 1) dor incapacitante localizada no médio e retropé; 2) deformidades marcadas pelo colapso do arco medial, valgo, abdução e supinação. Método Avaliamos 17 pacientes (20 pés) portadores de PPAA em estado avançado que foram submetidos à correção cirúrgica pela artrodese tríplice modelante. A média de idade dos pacientes no momento da cirurgia foi de 62 anos (variação de 38 a 79 anos), e o tempo médio de seguimento foi de 43 meses (variação de 18 a 84 meses). Utilizamos critérios clínicos empregando a escala visual analógica da dor (EVAD) e a escala funcional da American Orthopaedic Foot and Ankle Society (AOFAS, na sigla em inglês) do retropé para avaliar a eficácia da cirurgia. Resultados A dor residual mensurada pela EVAD foi de três pontos, em média. Observamos incremento médio de 23% nos valores da escala AOFAS do retropé após o tratamento cirúrgico. A correção das deformidades foi satisfatória em 10 de 20 pés; parcialmente satisfatória em 4 de 20 pés; parcialmente insatisfatória em 5 de 20 pés; e insatisfatória em 1 de 20 pés. Conclusão Apesar da artrodese tríplice modelante indicada no tratamento do PPAA em estágio avançado apresentar alto índice de consolidação óssea, a correção incompleta das deformidades pré-existentes e a persistência de dor residual contribuíram para a elevada taxa de decepção dos pacientes com o resultado da cirurgia.


Subject(s)
Humans , Male , Female , Adult , Arthrodesis , Flatfoot/surgery , Foot Deformities, Acquired
8.
Fisioter. Mov. (Online) ; 32: e003207, 2019. tab, graf
Article in English | LILACS | ID: biblio-984390

ABSTRACT

Abstract Introduction: Some peculiar features of Down Syndrome (DS), such as ligament laxity, hypotonia, delay in gait acquisition, among others, may generate alterations in the distribution of plantar pressures, modifying the plantar support. Objective: To verify whether there are differences in the evaluation of plantar pressure distributions in standing posture between the measurement instruments (Baropodometer, SAPO, and Radiography). Method: This was a cross-sectional study, evaluating ten children with SD and ten children with normal development (ND), aged from two to five years old. Bio-photogrammetry, baropodometry, and foot radiography were used to assess the plantar pressure distribution. Kappa analysis was used to evaluate the agreement index between the different instruments. Results: Children with DS and ND had a higher prevalence of pronated feet in all three instruments, with poor to substantial agreement among the instruments. Conclusion: According to this study instruments, there was a greater prevalence of pronated feet in the two groups . Differences in the evaluation of the distribution of plantar pressures in the standing posture between the Baropodometer, SAPO, and radiography were observed. These instruments should be used in a complementary manner, as they propose to evaluate different aspects of the feet alignment.


Resumo Introdução: Algumas características peculiares da Síndrome de Down (SD), como a frouxidão ligamentar, hipotonia, atraso na aquisição da marcha, dentre outras, podem gerar alterações na distribuição das pressões plantares, modificando o apoio plantar. Objetivo: Verificar se existem diferenças na avaliação da distribuição das pressões plantares, na postura de pé, entre os instrumentos de mensuração Baropôdometro, SAPO e Radiografia. Método: Estudo transversal que avaliou dez crianças com SD e dez crianças com desenvolvimento normal (DN), com idade entre dois e cinco anos. Para avaliação da distribuição das pressões plantares foram utilizados a biofotogrametria, baropodometria e radiografia dos pés. Foi utilizado a análise Kappa para avaliar o índice de concordância entre os diferentes instrumentos. Resultados: As crianças com SD e DN apresentaram maior prevalência de pés pronados nos três instrumentos, havendo concordância de pobre a substancial entre os instrumentos. Conclusão: Houve maior prevalência de pés pronados nos dois grupos de acordo com os instrumentos utilizados neste estudo. Foram encontradas diferenças na avaliação da distribuição das pressões plantares na postura de pé entre o Baropôdometro, SAPO e Radiografia, devendo estes instrumentos serem usados de forma complementar, já que se propõem a avaliar aspectos distintos do alinhamento dos pés.


Resumen Introducción: Algunas características peculiares del Síndrome de Down (SD), como la flojedad ligada, hipotonía, retraso en la adquisición de la marcha, entre otras, pueden generar alteraciones en la distribución de las presiones plantares, modificando el apoyo plantar. Objetivo: Verificar si existen diferencias en la evaluación de la distribución de las presiones plantares, en la postura de pie, entre los instrumentos de medición Baropôdometro, SAPO y Radiografía. Método: Estudio transversal que evaluó diez niños con SD y diez niños con desarrollo normal (DN), con edad entre dos y cinco años. Para la evaluación de la distribución de las presiones plantares se utilizaron biofotogrametría, baropodometría y radiografía de los pies. Se utilizó el análisis Kappa para evaluar el índice de concordancia entre los diferentes instrumentos. Resultados: Los niños con SD y DN presentaron mayor prevalencia de pies pronados en los tres instrumentos, habiendo concordancia de pobre a sustancial entre los instrumentos. Conclusión: Hubo una mayor prevalencia de pies pronados en los dos grupos de acuerdo con los instrumentos utilizados en este estudio. Se encontraron diferencias en la evaluación de la distribución de las presiones plantares en la postura de pie entre el Baropôdometro, SAPO y Radiografía, debiendo estos instrumentos ser utilizados de forma complementaria, ya que se proponen a evaluar aspectos distintos de la alineación de los pies.


Subject(s)
Child, Preschool , Child , Flatfoot , Down Syndrome , Child, Preschool
9.
Article in English | WPRIM | ID: wpr-765414

ABSTRACT

PURPOSE: This study examined the effects of flexible flatfeet on the accuracy of knee joint motions in closed and open kinetic chain tasks. METHODS: Twenty-four healthy participants were recruited for this study. The subjects were divided into two groups using a navicular drop (ND) test: flexible flatfoot group (n=12, male: 6, aged 22.00±2.22 years) and age-matched control group (n=12, males: 6, aged 22.17±1.53 years). The accuracy of knee motion was measured quantitatively by tracing through the flexion and extension motion of the knee joints in the closed kinetic chain and the open kinetic chain. RESULTS: There was a significant difference in the accuracy index between the groups in closed kinetic chain task, but there was no significant difference in the open kinetic chain task. In addition, there was a significant difference in the accuracy index between the closed kinetic chain and the open kinetic chain task in the flexible flatfoot group. In addition, a significant negative correlation was observed between the ND and accuracy index in the closed kinematic chain task, but there was no significant relationship between the ND and accuracy index in the open kinematic chain task. CONCLUSION: Flexible flatfeet can affect the accuracy of the adjacent joints, such as the knee joint in the closed kinematic chain.


Subject(s)
Flatfoot , Healthy Volunteers , Humans , Joints , Knee Joint , Knee , Male
10.
Article in English | WPRIM | ID: wpr-762623

ABSTRACT

OBJECTIVE: To evaluate the long-term effect of a custom-made rigid foot orthosis (RFO) in children older than 6 years with pes planus (flat foot). METHODS: Medical records of 42 children diagnosed with flexible pes planus who were fitted with RFOs based on the inverted technique and underwent more than four consecutive radiological studies were reviewed. Resting calcaneal stance position (RCSP), anteroposterior talocalcaneal angle, lateral talocalcaneal angle, lateral talometatarsal angle, and calcaneal pitch were initially measured in both feet to evaluate alignment. Followup clinical and radiological evaluations were then performed at 12–18, 24–30, 36–42, and ≥48 months after RFO application. Repeated measures analysis of variance was used to evaluate significant differences. RESULTS: Significant improvements in all radiological indicators and significant progression of RCSP toward the corrective direction were observed after RFO application relative to baseline measurements. CONCLUSION: According to our findings, RFO can induce significant improvements in calcaneus-related radiographic indices and subsequently improve talus-related radiologic indices.


Subject(s)
Child , Flatfoot , Follow-Up Studies , Foot Orthoses , Foot , Humans , Medical Records
11.
Article in English | WPRIM | ID: wpr-766142

ABSTRACT

OBJECTIVES: Flatfoot, or low medial longitudinal arch, contributes to back and lower extremity injuries and is caused by weak abductor hallucis (AbdH) muscles. The purpose of this study was to investigate the effects of short foot exercise (SFE) alone or with neuromuscular electrical stimulation (NMES) on navicular height, the cross-sectional area (CSA) of the AbdH muscle, and AbdH muscle activity in flexible flatfoot. METHODS: Thirty-six otherwise healthy people with flexible flatfoot were randomly assigned to a group that received SFE with placebo NMES treatment (the control group) or a group that received both SFE and NMES treatment (the experimental group). Each group received 4 weeks of treatment (SFE alone or SFE with NMES). Navicular height, the CSA of the AbdH muscle, and AbdH muscle activity were assessed before and after the intervention. RESULTS: No significant differences were found in navicular height or the CSA of the AbdH muscle between the control and experimental groups, while AbdH muscle activity showed a statistically significant difference between the groups (SFE=73.9±11.0% of maximal voluntary isometric contraction [MVIC]; SFE with NMES=81.4±8.3% of MVIC; p<0.05). Moreover, the CSA of the AbdH muscle showed a statistically significant increase after treatment in the SFE with NMES group (pre-treatment=218.6±53.2 mm²; post-treatment=256.9±70.5 mm²; p<0.05). CONCLUSIONS: SFE with NMES was more effective than SFE alone in increasing AbdH muscle activity. Therefore, SFE with NMES should be recommended to correct or prevent abnormalities in people with flexible flatfoot by a physiotherapist or medical care team.


Subject(s)
Electric Stimulation , Flatfoot , Foot , Humans , Isometric Contraction , Lower Extremity , Muscles , Patient Care Team , Physical Therapists , Thailand
12.
Article in Chinese | WPRIM | ID: wpr-776135

ABSTRACT

OBJECTIVE@#To explore short-term clinical effects of bone and soft tissue combined with surgery for the treatment of soft flatfoot accompanied with painful navicular bone.@*METHODS@#From May 2015 to August 2017, 16 patients (16 feet) with navicular bone soft flatfoot accompanied with painful navicular bone were treated with bone and soft tissues operation (gastrocnemius release, medial displacement calcaneal osteotomy, and excision of accessory navicular with reconstruction of posterior tibial tendon). Among them, there were 9 males (9 feet) and 7 females (7 feet), aged from 22 to 48 years old with an average of (32.0±3.4) years old. The duration of diseases ranged from 6 months to 5 years with an average of (2.4±1.7) years. The postoperative complications were observed, talocalcaneal angle, the first metatarsal horn of the talus, arch height, angle of inclination and calcaneal valgus before and after operation at 12 months were compared. VAS score and AOFAS score after operation at 12 months were applied to evaluate pain relief and function.@*RESULTS@#All patients were followed up for an average of (18.4±3.5) months(13~25 months). The incisions of patients were healed at grade A without wound infection, nonunion or delayed union, internal fixation fracture or loosening and other complications. Medial pain of foot was disappeared and motor ability was restored at 12 months after operation. Arch height, angle of inclination and the first metatarsal horn of the talus of lateral X-ray before operation and after operation at 12 months on weight-bearing foot were(21.51±1.20)°vs(31.01±1.62)°, (10.71±1.52)°vs(22.12±2.11)°, (15.61±1.41)°vs(5.10±1.20)°; talocalcaneal angle, the first metatarsal horn of the talus of AP X-ray before operation and after operation at 12 months on weight-bearing foot were (36.12±2.21) ° vs (22.12±2.61)°, (13.41±1.51)°vs(4.30±0.91)°; calcaneal valgus of axial X-ray before operation and after operation at 12 months on weight-bearing foot were (10.80±1.21)°vs(3.92±1.81)°; there were statistical difference in imaging indicators between preoperation and 12 months after operation. VAS score was significantly decreased from (6.21±2.31) before operation to (1.82±0.56) at 12 months after operation (=2.64, <0.05). AOFAS score was obviously increased from (51.2±5.6)before operation to (87.1±4.7)at 12 months after operation (=3.43, <0.05).@*CONCLUSIONS@#Bone and soft tissue operation (namely, gastrocnemius release, medial displacement calcaneal osteotomy, and excision of accessory navicular with reconstruction of posterior tibial tendon) could obviously relieve foot pain, improve foot appearance and function in patients with navicular bone soft flatfoot complicated with painful navicular bone, and has certain clinical efficacy.


Subject(s)
Adult , Female , Flatfoot , Humans , Male , Middle Aged , Osteotomy , Pain , Radiography , Tendons , Treatment Outcome , Young Adult
14.
Acta ortop. mex ; 32(2): 82-87, mar.-abr. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-1019335

ABSTRACT

Resumen: La insuficiencia del tendón del tibial posterior es la causa adquirida de dolor más común relacionada con la deformidad de pie plano valgo en adultos. El pie plano adquirido por el adulto es una deformidad sintomática muy dolorosa que resulta de un estiramiento gradual (atenuación) del tendón del tibial posterior, así como de los ligamentos que sostienen el arco de la planta del pie. El dolor progresivo en el pie plano adquirido por el adulto afecta cuatro veces más a las mujeres que a los hombres. Algunos factores que contribuyen a incrementar el riesgo del pie plano adquirido en el adulto son la diabetes, la hipertensión y la obesidad. Se piensa que la combinación de los eventos siguientes es la causa del pie plano adquirido por el adulto. La clasificación de Johnson Strom modificada por Mayerson lo evalúa en cuatro estadios. Este estudio se dividió en tres etapas: etapa 1: disección y análisis tridimensional del tendón, etapa 2: aplicación de herramientas de bioingeniería para determinar las causas de ruptura del tendón del tibial posterior y etapa 3: evaluación de 24 pacientes con enfermedad de pie plano valgo para describir la deformidad.


Abstract: The insufficiency of the posterior tibial tendon is the most common acquired cause of pain related to valgus flatfoot deformity in adults. The acquired flatfoot adult is a very painful symptomatic deformity resulting from a gradual stretching (attenuation) of the posterior tibial tendon and ligaments that support the arch of the foot. The progressive pain acquired flatfoot adult affects four times more women than men. Some factors that contribute to increased risk of acquired flatfoot in adults, are diabetes, hypertension and obesity. It is thought that the combination of the following events is the cause of acquired flatfoot adult. Johnson Strom classification modified by Mayerson evaluates in 4 stages. This study was divided into 3 stages: Stage 1: Dissection and three-dimensional analysis of the tendon, Step 2: Application of tools bioengineering to determine the causes of rupture of the tibial tendon: Stage 3: Evaluation of 24 patients with flatfoot disease valgus for describe the deformity.


Subject(s)
Humans , Male , Adult , Flatfoot/complications , Posterior Tibial Tendon Dysfunction/etiology , Rupture , Tibia , Foot
15.
Rev. Col. Bras. Cir ; 45(6): e1969, 2018. tab, graf
Article in Portuguese | LILACS | ID: biblio-976936

ABSTRACT

RESUMO O pé plano flexível é condição frequente na criança pequena e apresenta forte tendência para correção espontânea, ou tornar-se moderado ou leve no adulto, o que não causará problemas futuros. Entretanto, em uma pequena proporção de casos a deformidade é mais grave, não melhora, o que pode levar ao comprometimento do desempenho mecânico, deformidade e, eventualmente, dor. Nestes casos o tratamento cirúrgico deve ser considerado. O objetivo desta revisão sistemática foi avaliar os resultados da literatura no tratamento do pé plano flexível sintomático da criança ou adolescente por um procedimento bastante frequente que é a osteotomia de alongamento da coluna lateral do calcâneo. Foi realizada busca sistemática eletrônica nas bases de dados PubMed, Web of Science, Cochrane, CINAHL, SciELO, SCOPUS e LILACS por artigos publicados entre março de 1975 e setembro de 2016. Após aplicação dos critérios de elegibilidade, os artigos selecionados foram avaliados quanto aos resultados clínicos, radiográficos e complicações. Dos 341 artigos encontrados nas bases de dados, apenas oito estudos foram selecionados, segundo os critérios de inclusão e exclusão, com um total de 105 pacientes e 167 pés tratados. Somente três autores realizaram estudo prospectivo, mas sem caso controle ou aleatorização. A maioria das publicações no período avaliado é composta por estudos descritivos ou série de casos (nível de evidência III ou IV), com grandes variações metodológicas, mas com alto índice de satisfação dos pacientes e cirurgiões, em relação aos resultados. Entretanto, são necessárias pesquisas com desenho prospectivo, aleatorizado, grupo controle adequado e critérios de avaliação validados.


ABSTRACT Flexible flatfoot is a common condition in small children, which shows a strong tendency to spontaneously correct with their growth or to become moderate or mild in adults, which will not cause future problems. However, in a small number of cases, this condition is more severe, does not improve spontaneously, which may cause mechanical impairment, deformity, and, eventually, pain. In such cases, surgical treatment should be considered. The aim of this systematic review was to evaluate the literature results on the treatment of the symptomatic flexible flatfoot in children or adolescents through a very frequent procedure: calcaneal lateral column lengthening osteotomy, A systematic electronic search in PubMed, Web of Science, Cochrane, CINAHL, SciELO, SCOPUS and LILACS databases was performed. We searched articles published between March 1975 and September 2016. After applying the eligibility criteria, the selected publications were evaluated in relation to their clinical and radiographic results and complications. We found 341 articles in the mentioned databases, but selected only eight studies, according to the inclusion and exclusion criteria. These studies included a total of 105 patients and 167 treated feet. Only three authors performed prospective studies, but without case-control or randomization. The majority of publications were descriptive studies or case series (level of evidence III or IV), with great methodological variations, but with a high satisfaction rate on the part of both patients and surgeons in relation to the results. However, more prospective and randomized studies are required, with adequate control groups and validated evaluation criteria.


Subject(s)
Humans , Child , Adolescent , Osteotomy/methods , Bone Lengthening/methods , Calcaneus/surgery , Flatfoot/surgery , Postoperative Complications , Postoperative Period , Calcaneus/diagnostic imaging , Flatfoot/diagnostic imaging , Prospective Studies , Retrospective Studies , Follow-Up Studies , Treatment Outcome
16.
Article in Korean | WPRIM | ID: wpr-717528

ABSTRACT

PURPOSE: Pes planovalgus is one of the most common foot deformities among pediatric orthopedic diseases and is divided into idiopathic and neuromuscular planovalgus according to its etiology. This study evaluated the radiologic and pedobarographic outcomes of the treatment for pes planovalgus in children treated with lateral column lengthening, compared the outcomes according to the etiology, and investigated the correlation between the radiologic and pedobarographic findings. MATERIALS AND METHODS: Sixty-three patients (97 feet), who underwent lateral column lengthening, were divided into groups of 30 patients (47 feet) with neuromuscular disease and 33 patients (50 feet) with idiopathic etiology. The preoperative, immediately postoperative, 1 year, and 3 year follow-up radiographic measurements on the plain radiograph antero-posterior (AP) and lateral view were compared. In pedobarography, the foot pressures were subdivided into 4 areas to measure the contact time, contact area, peak pressure, and maximum force. The pre- and postoperative pedobarographic measurements were compared and the correlations between the radiographic and pedobarographic measurements were evaluated. RESULTS: The radiographic index at the 1st postoperative year and 3rd postoperative follow-up did not show significant differences according to the etiology. In pedobarography, idiopathic planovalgus showed a significant increase in the maximum force in the hindfoot and forefoot. The correlation between the radiologic findings and pedobarographic findings was statistically significant between the tibiocalcaneal angle in the lateral view and the maximum force, and the contact area of hindfoot on pedobarography, between tibiocalcaneal angle in the lateral view and the contact area of the toes in idiopathic planovalgus. In neuromuscular planovalgus, the peak pressure in the hindfoot had a strong negative correlation with talonavicular coverage angle in the AP view and talo-1st metatarsal angle, and the talohorizontal angle in the lateral view. CONCLUSION: Lateral column lengthening is an effective surgical procedure for flatfoot patients. On the other hand, the radiographic examination has limitations for accurate assessments of the postoperative results and prognosis. Qualitative and quantitative evaluations are available by pedobarography and it is a useful instrument for an evaluation of planovalgus when used in conjunction with radiography.


Subject(s)
Child , Evaluation Studies as Topic , Flatfoot , Follow-Up Studies , Foot , Foot Deformities , Hand , Humans , Metatarsal Bones , Neuromuscular Diseases , Orthopedics , Prognosis , Radiography , Toes
17.
Clinical Pain ; (2): 81-90, 2018.
Article in Korean | WPRIM | ID: wpr-786713

ABSTRACT

OBJECTIVE: To evaluate the long termeffect of custom-molded foot orthoses on foot pain and balance ability in children with symptomatic flexible flat feet after 1 year.METHOD: A total of 35 children over 6 year-old with flexible flat feet and foot pain for at least 6 months were recruited. Individual custom-molded rigid foot orthoses fabricated with the inverted orthotic technique was prescribed. Pain related parameters (pain sites, degree, and frequency) were obtained through questionnaires. Pain assessment was performed prior to application of the foot orthoses, and 1, 3, 6, 12 months after applying the orthoses. Balance ability was tested by computerized posturography. Such measures were evaluated prior to, 3 months, and 12 months after applying the foot orthoses. Additionally, the difference inbalance ability between barefoot and withfoot orthosesat 12 months was assessed to estimate carryover effect.RESULTS: 17 out of 35 children completed the study. Significant improvements were noted upto 12 months in pain parameters and balance ability. The carry over effect of the orthoses was confirmed.CONCLUSION: There were significant improvements offoot pain and balance ability in children with symptomatic flexible flat foot after wearing foot orthoses fabricated with the inverted orthotic technique over 1year period.


Subject(s)
Child , Flatfoot , Foot Orthoses , Foot , Humans , Methods , Orthotic Devices , Pain Measurement , Pediatrics , Postural Balance
18.
Clinical Pain ; (2): 16-25, 2018.
Article in Korean | WPRIM | ID: wpr-786703

ABSTRACT

As the aging of the foot progresses, the stiffness of the soft tissues, the reduction of the range of motion, the decrease of the muscle strength, and the flattening of foot are manifested. These changes increase the risk of foot pain, the problem of weight distribution and transmission, and the risk of falls, resulting in secondary complications and lowering quality of life. The most common deformities and diseases of the elderly foot are hallux valgus, hammertoes, hallux rigidus, Achilles tendinitis, plantar fasciitis, metatarsalgia, hyperkeratosis, and other deformities of the feet caused by chronic conditions. Systemic diseases that promote these foot problems include diabetes, peripheral nerve damage, repetitive ankle ligament injuries, deformities due to fractures, and obesity. Understanding the mechanisms of aging and the processing of biomechanics in the elderly will enable them to reach a healthy life through appropriate rehabilitation, exercise and educations during aging. In addition, it is necessary to promote the healthy life in elderly by customized exercise, training, and shoes.


Subject(s)
Accidental Falls , Aged , Aging , Ankle , Congenital Abnormalities , Fasciitis, Plantar , Flatfoot , Foot Diseases , Foot , Hallux Rigidus , Hallux Valgus , Humans , Ligaments , Metatarsalgia , Muscle Strength , Obesity , Peripheral Nerves , Quality of Life , Range of Motion, Articular , Rehabilitation , Shoes , Tendinopathy
19.
Med. infant ; 24(4): 325-328, dic. 2017. tab, ilus
Article in Spanish | LILACS | ID: biblio-878279

ABSTRACT

Introducción: El pie plano flexible es una de las entidades ortopédicas más frecuentes en Pediatría. Algunos autores lo consideran una variante anatómica. La incertidumbre en cuanto a su evolución y pronóstico, sumado a la preocupación y demanda por parte de los padres, hace que en muchas ocasiones se indique tratamiento ortésico. Metodología: se realizó una búsqueda sistemática en Medline, Lilacs, Cochrane y Google académico, usando los términos therapy, flatfoot, flatfeet, pie plano y pes planus; población hasta los 18 años, publicaciones hasta abril 2017 y restringiendo por idiomas español e inglés. Para el aná- lisis de los artículos se utilizaron la guía de lectura crítica del Hospital Garrahan y la escala de calidad metodológica JADAD. Resultados: de 778 artículos encontrados, 421 correspondían a pacientes con enfermedad de base, 194 evaluaban corrección quirúrgica, 144 eran descriptivos, 7 comparaban diferentes ortesis entre sí y 7 eran revisiones de trabajos. Finalmente fueron analizados 5 trabajos (cuatro ECCAs y un estudio de cohorte). De los 5 artículos, 2 poseían aceptable y muy buena calidad metodológica según la escala JADAD, ninguno demostrando diferencias significativas con el tratamiento ortésico. De los 3 restantes, sólo uno halló mejores resultados en cuanto al alivio del dolor y de la marcha combinando ortesis con ejercicios (RR 0.33 y 0.29 respectivamente). Conclusión: en base a esta revisión no hay evidencia científica que demuestre la eficacia del uso de ortesis para la corrección del pie plano flexible en la población pediátrica sana.(AU)


Introduction: Flexible flatfoot is one of the most common orthopedic findings in children. Some authors consider the entity to be a normal anatomical variant. Uncertainty regarding outcome and prognosis added to the worries and demands of the parents often results in the indication of orthotic treatment. Methods: A systematic search was conducted in Medline, Lilacs, Cochrane, and Google academics using the terms therapy, flatfoot, flatfeet, and pes planus; population up to 18 years of age, publications until April 2017, in Spanish and English. For the analysis of the articles the critical reading guidelines of Hospital Garrahan and the JADAD scale for methodological quality were used. Results: Of 778 articles found, 421 were related to patients with an underlying disease, 194 evaluated surgical correction, 144 were descriptive studies, 7 compared different orthosis, and 7 were review studies. Finally, 5 studies were analyzed (four randomized controlled trials (RCT) and one cohort study). Of the five studies, two were considered acceptable and of good quality on the JADAD scale. None of the studies showed significant differences with orthotic treatment. Of the three remaining studies, only one found better results regarding pain relief and gait improvement with orthosis combined with exercise (RR 0.33 and 0.29, respectively). Conclusion: Based on this review, there is no scientific evidence that shows efficacy of the use of orthosis for the correction of flatfoot in healthy children. (AU)


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Flatfoot/therapy , Foot Orthoses , Treatment Outcome
20.
Int. j. morphol ; 35(4): 1403-1408, Dec. 2017. tab
Article in Spanish | LILACS | ID: biblio-893149

ABSTRACT

RESUMEN: Se sabe que hay gran variabilidad en la morfología de las zonas del pie entre sujetos. Esto es más evidente en deportistas, ya que la práctica de deportes somete a los pies a presiones y deformaciones anatómicas mayores que las que se ejercen en actividades de la vida diaria. Por lo anterior, se desprende que el conocimiento de la morfología del pie de la población objetivo es de alto interés para la confección de calzado apropiado a su forma y dimensiones. El objetivo de esta investigación es caracterizar variables morfológicas referidas a las dimensiones del pie de deportistas seleccionados universitarios chilenos. La muestra se conformó de 169 sujetos de ambos sexos de una población de deportistas universitarios de 23,27 años, 71 kilogramos, 1,71 metros de estatura e índice de masa corporal de 24,29. En las mediciones se utilizó un antropómetro y la clasificación del Arco Plantar Longitudinal Medial (APLM) se realizó mediante el Arch Index. Se demostró que la longitud del pie en hombres y mujeres se corresponde con el 15 % de la estatura del sujeto. La variable Ancho Antepie Normalizado (AAN) equivale al 39 % de la Longitud del Pie (LP), no registrándose diferencias entre sexos. El Ancho del Retropié por su parte, fue correspondiente con el 25 % de LP. El Ancho de Retropie (AR) equivale al 63 % del Ancho Antepie (AA). En cuanto al APLM, las mujeres presentan valores de normalidad ubicados entre 0,13 y 0,24 para pie izquierdo y 0,17 y 0,24 para pie derecho. Se aprecia que la prevalencia de pies planos fue mayor en hombres (25 % a 28 %) que en mujeres (4 % a 6 %) y la prevalencia de pies cavos fue mayor en mujeres (47 % a 53 %) respecto a hombres (27 % a 31 %).


SUMMARY: It is known that there is great variability in the morphology of feet areas among different subjects. This is more evident in athletes, since the practice of sports subjects their feet to greater pressures and anatomical deformations, other than those exerted during daily life activities. It is clear therefore, that knowledge of the target population foot morphology is of high interest for the production of appropriate footwear to its shapes and dimensions. The objective of this research is to characterize morphological variables related to the feet of selected Chilean university athletes. The sample consisted of 169 subjects of both sexes of university population athletes of an average age of 23.27 years, 71 kilograms, 1.71 meters height and body mass index of 24.29. An anthropometer was used for measurements and the classification of the Medial Longitudinal Plantar Arch (MLPA) was performed by the Arch Index. It was shown that foot length corresponds to 15 % of the subject's height. The Normal Forefoot Width (NFW) variable is equal to 39% of Foot Length (FL), with no differences between sexes. Posterior foot width corresponded to 25 % of LP; posterior foot Width is 63 % of the Forefoot Width (AA). Regarding the APLM, women presented values of normality located between 0.13 and 0.24 for left foot and 0.17 and 0.24 for right foot. The prevalence of flat foot was higher in men (25 % to 28%) than in women (4 % to 6 %) and the prevalence of cavus foot was higher in women (47 % to 53 %) than in men (27 % to 31 %).


Subject(s)
Humans , Male , Female , Adult , Young Adult , Sports , Flatfoot/epidemiology , Talipes Cavus/epidemiology , Foot/anatomy & histology , Flatfoot/pathology , Chile , Anthropometry , Prevalence , Cross-Sectional Studies , Sex Distribution , Talipes Cavus/pathology
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