Influence of a metatarsus adductus foot type on plantar pressures during walking in adults using a pedobarograph.

Metatarsus adductus is a relatively common congenital foot deformity that is often unrecognized at birth. Thus, the adult foot with metatarsus adductus is prone to pathologic entities that have been theorized to result from lateral column overload. We present a descriptive study comparing plantar foot pressure distribution during gait in subjects with and without metatarsus adductus. A total of 65 subjects were recruited for the study: 28 subjects with and 37 subjects without metatarsus adductus. An EMED(®) pedobarograph was used to collect the data. The analysis of the peak pressure and pressure-time integral in each of the 8 regions of the plantar surface of the foot showed significant (p < .05) differences between each of the regions and a significant (p < .05) interaction effect between the 8 regions and the 2 groups. A series of independent Student's t tests were therefore performed to determine which of the plantar regions showed a significant difference between the 2 groups. The result of those t tests showed that the peak pressure and pressure-time integral were significantly different (p < .05) between the 2 groups for the "heel," "lateral midfoot," and "lateral forefoot." The results of the present study support the concept that during gait, the adult foot with metatarsus adductus has increased peak plantar pressures on the lateral side of the foot.

Digital fracture after a flexor tendon transfer for hammertoe repair: a case report.

The authors present a case report of a complication of a complete phalangeal fracture after flexor digitorum longus tendon transfer used for the surgical correction of a hammertoe deformity.

The influence of first ray mobility on forefoot plantar pressure and hindfoot kinematics during walking.

BACKGROUND: Hypomobility and hypermobility of the first ray have been implicated in the literature as a primary cause of mechanical foot problems because of proposed obligatory and compensatory movements. Despite these theoretical links, research is sparse regarding the effect on kinematic and plantar pressure patterns as a result of altered first ray mobility. The purpose of this study was to determine whether hypomobility or hypermobility of the first ray alters hindfoot kinematics or the distribution of plantar pressures during walking. METHODS: The magnitude of dorsal first ray mobility in 82 individuals was measured and then classified as being hypomobile, normal, or hypermobile. The plantar pressure under the first and second metatarsal heads, as well as hindfoot kinematics during walking, were then compared between the three categories of first ray mobility. RESULTS: The results of this study indicate that those feet with a hypomobile first ray had significantly decreased plantar force and pressure values under the first metatarsal compared to the second metatarsal. In addition, feet with a hypomobile first ray showed significantly more hindfoot eversion compared to those with either normal or hypermobile first rays. CONCLUSION: The results of this study do not support the common theoretical implications of altered mobility of the first ray related to plantar pressure and hindfoot kinematics.

Reliability of visual measurement of forefoot alignment.

BACKGROUND: The purpose of this study was to determine the interrater reliability of visual rating of forefoot frontal plane deformities among clinicians with different training. METHODS: Thirty individuals (16 men and 14 women) between the ages of 22 and 52 years of age participated in the study. None of the patients had a history of congenital deformity, pain, or trauma in the lower extremities during the 6 months before the study. Three clinicians of different educational backgrounds and experience visually evaluated each of the patients and rated forefoot alignment. None of the clinicians knew the rating assigned by either of the other two clinicians. RESULTS: The results of this study showed that two of the clinical raters agreed 61.7% of the time, but neither of them agreed with the third clinician more than 15% of the time. CONCLUSION: This study indicates that the commonplace method of visually rating forefoot frontal plane deformities is unreliable and of questionable clinical value.

Reliability and validity of clinically assessing first-ray mobility of the foot.

The objective of the present study was to determine the amount of agreement among three clinicians in the clinical assessment of dorsal mobility of the foot's first ray and the agreement between their assessments and that of a mechanical device designed to quantify first-ray mobility. Sixty feet from 30 individuals evaluated clinically by three health-care professionals were classified as having a hypomobile, normal, or hypermobile first ray. The amount of first-ray dorsal mobility of each participant's foot was then measured using a device specifically constructed for that purpose. The results of this study show generally poor agreement among the three clinicians on whether a foot should be classified as having hypomobility, hypermobility, or normal mobility of the first ray. The amount of agreement with the quantitative device was poor for two of the clinicians and moderate for the third clinician.

Gait analysis after talonavicular joint fusion: 2 case reports.

The purpose of this study was to analyze the alterations in frontal-plane hindfoot motion and in plantar pressure in 2 patients (3 feet) after talonavicular joint fusion. Three-dimensional movement of the hindfoot was recorded by using an electromagnetic motion analysis system. The results indicated that frontal-plane hindfoot motion of the operative foot was substantially reduced during the stance phase of walking. In addition, each patient's frontal-plane hindfoot angle while in the resting standing position was decreased and plantar pressure under the medial longitudinal arch was reduced after surgery.