Dynamic pedobarography (DPB) was performed in 21 patients, 9 male and 12 female with cavovarus foot deformity mostly of Charcot-Marie-Tooth origin. Age ranged from 14 to 52 years (mean 30y). Twenty-six feet were examined pre- and postoperatively clinically, radiologically and by dynamic pedobarography with a follow-up time from 9 to 49 months (mean 22.5 mo). The EMED SF system was used for data collection during walking. Gait line, contact areas (CA), peak pressures (PP) and pressure time integral (PTI) were determined. According to the contact pattern the examined feet could be divided into three groups with antegrade, retrograde and inversion contact pattern. Data analysis showed postoperatively considerable increase in CA and decrease in PP and PTI. Clinical results such as plantar callosities and “roll over avoidance gait” did not always correlate with pedobarographic data. DPB adds a dynamic component in the diagnosis and management of cavovarus feet but certain limitations exist.
Get full access to this article
View all access options for this article.
References
1.
. AlexanderIJJohnsonKA. Assessment and Management of Pes Cavus in Charcot-Marie-Tooth Disease. Clin Orth and Rel Res, 246: 273–281, 1989.
2.
. BaummanJUKochHG. Ventrale aponeurotische Verlangerung des Muskulus gastrocnemius. Opera Orthop Traumatol, 1: 254–258, 1989.
3.
. BowenTRMillerFCastagnoPRichardsJLiptonG.A method of dynamic foot-pressure measurement for the evaluation of the paediatric orthopaedic foot deformities. J Pediatr Orthop, 18: 789–793, 1998.
4.
. BrandP.W.The diabetic foot. In EllenbergM ed. Diabetes mellitus: theory and practice, 3rd edn, New York, Medical Examination Publishing, p 829–849, 1983.
5.
. CavanaghPRUlbrechtJS. Clinical plantar pressure measurement in diabetes: rationale and methodology. The Foot, 4: 123–135, 1994.
6.
. CavanaghPR. Emed scientific meeting, Penn State, 1996.
7.
. CavanaghPRPerryJEUlbrechtJSDerrJAPammerSE. Neuropathic diabetic patients do not have reduced variability of plantar loading during gait. Gait Posture, 7(3): 191–199, 1998.
8.
. ColeWH. The treatment of claw-foot, J Bone Joint Surg, 4A: 895–908, 1940.
9.
. ColemanSSChesnutWJ. A simple test for the hindfoot flexibility in the cavovarus foot, Clin. Orthop., 123:60–62, 1977.
10.
. DuckworthTBoultonAJMBettsRPFranksClWardJD. Plantar pressure measurements and the prevention of ulceration in the diabetic foot. J Bone Joint Surg, 67B, 79–85, 1985.
11.
. DuckworthT, In HelalBWilsonD ed. The Foot, Churchill Livingstone, Edinburgh; p 108–130, 1988.
12.
. DuckworthT.In Jahss, Disorders of the foot and ankle, medical and surgical management, W.B. Saunders, Philadelphia, p 517, 1991.
13.
. DwyerFC. Osteotomy of the calcaneum for pes cavus. J Bone Joint Surg, 41B: 80–86, 1959.
14.
. FullerE.Computerized gait evaluation. In ValmassyRL ed. Clinical Biomechanics of the Lower Extremities. Mosby, St. Louis: 180–205, 1996.
15.
. GibbsRCBoxerMC. Abnormal biomechanics of feet and their cause of hyperkeratoses. J Am Acad Dermatol, 6:1061–1069, 1982.
16.
. HarrisonAJFollandJP. Investigation of gait protocols for plantar pressure measurement of non-pathological subjects using a dynamic pedobarograph. Gait Posture, 6: 50–57, 1997.
17.
. HelalB.Metatarsal osteotomy for metetarsalgia. J Bone Joint Surg, 57B: 187–192, 1975.
18.
. HennigEMRosenbaumD.Pressure distribution patterns under the feet of children in comparison with adults, Foot ankle, 11: 306–311, 1991.
19.
. HibbsRA. An operation for iclaw footi. J Am Med Ass, 73: 1583–1585, 1919.
20.
. HohmannG.Der Hallux valgus und die übrigen Zehenverkrümmungen. Erg Chir Orthop, 18: 308–376, 1925.
. HughesJClarkPKlenermanL.The importance of the toes in walking. J Bone Joint Surg, 72B: 245–251, 1990.
26.
. HughesJPrattLLingeKClarkPKlenermanL.Reliability of pressure measurements: the EMED F system. Clin Biomech, 6: 14–18, 1991.
27.
. HughesJ.The clinical use of pedobarography. Acta Orthop Belg, 59: 9–16, 1993.
28.
. JahssMH. Tarsometatarsal truncated-wedge arthrodesis for pes cavus and equinovarus deformity of the fore part of the foot. J Bone Joint Surg, 62A: 713–722, 1980.
29.
. JahssMH. Evaluation of the cavus foot for orthopaedic treatment. Clin Orth Rel Res, 181: 52–63, 1983.
30.
. JapasLM. Surgical treatment of pes cavus by tarsal V-osteoto- my. J Bone Joint Surg, 50A: 927–944, 1968.
31.
. JonesR.The soldier's foot and the treatment of the common deformities of the foot. Br Med J, 1: 749–752, 1916.
32.
. LambrinudiC.New operation on drop-foot. Br J Surg, 15:193–200, 1927.
33.
. LevittRLCanaleSTCookeAJGartlandJJ. The role of foot surgery inprogressive neuromuscular disorders in children, J Bone Joint Surg, 53A: 1396–1410, 1973.
. MannDCHsuJD. Triple arthrodesis in the treatment of fixed cavovarus deformity in adolescent patients with Charcot-Marie-Tooth disease. Clin Orth Rel Res, 13:1–6, 1992.
36.
. MannRA. In MannRACoughlinMJ, ed. Surgery of the foot and ankle. Mosby-Year Book, St. Louis, p 785–801, 1993.
. MéaryR: Symposium sur le pied creux essentiel. Rev Chir Orthop Reparatrice Appr Mot, 53: 389–467, 1967.
39.
. MoscaVS. The child's foot: principles of management (editorial). J Pediatr Orthop, 18: 281–282, 1998.
40.
. O'DochertyD.The foot and ankle, in PywsentPFairbankJCarrA ed. Outcome measures in orthopaedics, Butterworth-Heinemann, Oxford, p 245–268, 1993.
41.
. OganesyanOVIstominaISKuzminVI. Treatment of equinocavovarus deformity with the use of a hinged distraction apparatus. J Bone Joint Surg, 78A: 546–556, 1996.
42.
. PaulosLColemanSSSamuelsonKM. Pes cavovarus. J Bone Joint Surg, 62A: 942–953, 1980.
43.
. PerryJ. in PerryJ, ed. Gait analysis, normal and pathological function, Thorofare, NJ, Slack Inc, p 427, 1992.
44.
. PerryJ. in PerryJ, ed. Gait analysis, normal and pathological function, Thorofare, NJ, Slack Inc, 206–207, 1992.
. ShereffMJ. Radiographic analysis of the foot and ankle. In JahssMH (ed): Disorders of the foot and ankle: medical and surgical management, W.B. Saunders, Philadelphia, p 104, 1991.
47.
. SinghD.BentleyG.TrevinoSG. Callosities, corns and calluses. BMJ, 312: 1403–1406, 1996.
. SteindlerA.Stripping of the os calcis. J Orthop Surg, 2: 8, 1920.
50.
. YoungMJCavanaghPRThomasGJohnsonMMMurrayHBoultonAJM. The effect of callus removal on dynamic plantar foot pressures in diabetic patients. Diabetic Med, 9: 55–57, 1992.
