The kinematic coupling during Ponseti correction in idiopathic clubfoot: A quantitative analysis

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2024-11-19 DOI:10.1016/j.jcot.2024.102831

Anil Agarwal , Sitanshu Barik , Yogesh Patel , Abdus Sami , Mohit Gera

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引用次数: 0

Abstract

Background

The study aimed to quantify and correlate kinematic coupling linkage of foot abduction (correction of adduction) and inversion, heel varus and ankle equinus for clubfeet corrected by Ponseti technique.

Methods

Measurements of foot abduction (derotation of carpopedal block), heel varus and ankle equinus were available from Dimeglio scores in 25 feet. Radiological angles were considered for foot inversion-eversion. Values of above parameters were obtained at the start of treatment (T1), pre tenotomy (T2) and after tenotomy (T3). The values of T2-T1 corresponded to the manipulative phase of Ponseti technique while T3-T2 corresponded to the Achilles tenotomy.

Results

During the manipulative phase, coupling rhythm between foot abduction to correction of equinus, heel varus and inversion was calculated to be 1:0.3, 1:1.1 and 1:0.5 respectively. Post tenotomy, coupling rhythm between ankle dorsiflexion to changes in foot abduction, heel varus and inversion was calculated to be 1:0.5, 1:0.1 and 1:0.4 respectively. A moderate significant correlation was obtained on comparison of T3-T2 values between clinical equinus and foot abduction (r = 0.54, p = 0.05).

Conclusion

The foot inversion, heel varus and ankle equinus corrected at 1.1, 0.5 and 0.3 times respectively of foot abduction in the manipulative phase. The phenomenon of kinematic coupling between various foot movements was however inconsistent during Ponseti treatment of clubfoot. More significant associations were obvious towards late phase of deformity correction when foot alignments were much improved. Larger prospective studies are needed to delineate the precise linkage between foot movements in a pathological condition such as clubfoot.

Level of evidence - II.

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特发性马蹄内翻足在 Ponseti 矫正过程中的运动耦合：定量分析

背景该研究旨在量化和关联通过 Ponseti 技术矫正的马蹄内翻足的足外展（内收矫正）和内翻、足跟外翻和踝关节等位的运动耦合联系。足内翻-外翻的放射学角度被考虑在内。上述参数值分别在治疗开始时（T1）、腱膜切开术前（T2）和腱膜切开术后（T3）获得。结果在操作阶段，足外展与矫正马蹄内翻足、足跟外翻和足内翻之间的耦合节奏分别为 1:0.3、1:1.1 和 1:0.5。韧带切除术后，踝关节外展与足外展、足跟内翻和足内翻变化之间的耦合节律分别为 1:0.5、1:0.1 和 1:0.4。临床马蹄内翻足与足外展之间的 T3-T2 值比较结果呈中度显着相关性（r = 0.54，p = 0.05）。然而，在庞塞蒂治疗马蹄内翻足的过程中，各种足部运动之间的运动耦合现象并不一致。在畸形矫正的后期，足部排列得到了很大改善，此时足部运动之间的关联更为明显。需要进行更大规模的前瞻性研究，以确定足部运动在足外翻等病理情况下的确切联系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.