Abstract
Purpose of study: The aim of this study was twofold. Firstly, to compare a subjective clinical with an objective biomechanical assessment of operated clubfeet, using the optical Dynamic Pedobarograph foot pressure system. Secondly, to develop the latter into a classification system for future prospective studies and to complement clinical evaluation of patients, especially those with relapse.
Methods and results: Sixteen patients (21 feet) were randomly selected from a pool of patients that had undergone clubfoot surgery. The operations were carried out by a single surgeon and consisted of a lateral-posteromedial peritalar release utilising the Cincinnati incision. Post-operatively, all feet were independently classified using a modified functional outcome scoring system. After completion of treatment, patients were referred to the Foot Pressure Analysis Clinic in Dundee where a novel method has been developed for the evaluation of clubfeet, using a static and dynamic foot pressure analysis system which provide both a graphical and analytical model for comparison. A three point grading scale was developed. The correlation between clinical and biomechanical outcomes in the 21 feet was calculated using Kendall’s tau rank test for non-parametric data. The t value was 0.3524, which was significant (p < 0.05).
Conclusion: There is a significant correlation between the above mentioned subjective and objective outcome measurements. Biomechanical assessment can complement, support or change the line of management after clubfoot surgery. This technique has not only proven to be objective but also clinically valuable and cost effective. A prospective study to refine this biomechanical classification into a reliable predictor of relapse in surgically corrected clubfeet is currently being considered
Local Host: British Society for Children’s Orthopaedic Surgery. Conference Theme: Congenital Deficiencies of the Lower Limb. These abstracts were prepared by A.Catterall.
