RESUMO
Results of talectomies in 19 patients with severe foot deformities secondary to myelomeningocele were evaluated with an average follow-up of 12 years, 7 months. Although an apparently plantigrade foot was usually obtained, talectomy rarely succeeded in distributing weightbearing forces uniformly over the plantar surface. Photoelastic force-plate analysis incorporating three-dimensional contour mapping clearly identified areas of high ground-foot reaction forces (GFRs) and high-pressure gradients. We suggest that such high-pressure areas predispose these patients to neurotrophic ulceration.
Assuntos
Deformidades Congênitas do Pé/cirurgia , Meningomielocele/complicações , Tálus/cirurgia , Adolescente , Adulto , Braquetes , Criança , Pré-Escolar , Feminino , Deformidades Congênitas do Pé/complicações , Deformidades Congênitas do Pé/etiologia , Humanos , Masculino , Pressão , Úlcera por Pressão/etiologiaRESUMO
This paper describes a system for evaluation of ground-foot reaction forces in which multiple 1 centimeter diameter metal coated points transmit pressure to a photoelastic sheet. The pressure generates circular interference patterns, the diameters of which are linearly related to the pressure applied. The system permits the computerized construction of a three-dimensional contour map which can be compared to a pedobarograph. The qualitative/quantitative assessment system can identify areas on the plantar aspect of the foot at risk for skin breakdown. This information will permit treatment to proceed on a more rational basis than has been possible heretofore.