Biomechanical assessment of two different surgical treatments for the correction of flat foot
© Berti et al; licensee BioMed Central Ltd. 2014
Published: 8 April 2014
The flat foot is a very frequent deformity in orthopedics and can be observed at different levels of severity already in childhood and infancy. The possible functional alterations associated with flat feet are not fully established. These can result in critical clinical consequences, such as secondary deformities of the forefoot and lower limb, pain and muscle fatigue. The prescription of orthotics or indication for surgical interventions are still much debated. A diagnosis based only on foot morphology is not sufficient to decide the therapeutic approach. In fact, the degree of severity of the deformity and the effects of treatments require also careful functional assessment. This study aims at investigating by means of movement analysis the effects of two different surgical treatments for severe flat foot.
Ten children (11.3 ± 1.6 yrs, 19.7 ± 2.8 BMI) were operated for the correction of flat foot [1, 2] in both feet. One foot was corrected with a calcaneo-stop method, i.e. a screw implanted into the calcaneus, and the other with an endoprosthesis implanted into the sinus-tarsi. Gait analysis was performed pre- and 12 month post-operative, using a 8-camera motion system (Vicon, UK). An established protocol for lower limb  and a multi-segment foot kinematic analysis  were used to calculate joint rotations and moments during three walking trials for each subject.
The combined lower limb and multi-segment foot kinematics analyses was found adequate and provided a thorough and accurate functional assessment of the entire limbs. Both surgical treatments enabled good restoration of the normal kinematics of the foot and of the lower limb joints. This population will be monitored further to assess the functional progresses in time; preservation, or even improvement, of these results, are expected.
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