Gait analysis after initial nonoperative treatment for clubfeet: Intermediate term followup at age 5

Lori A. Karol, Kelly Jeans, Ron Elhawary

Research output: Contribution to journalArticle

34 Scopus citations

Abstract

We conducted gait analysis following initial nonoperative clubfoot treatment to compare lower extremity kinematic (eg, ankle motion) and kinetic (eg, ankle power) characteristics between patients treated as infants with Ponseti casting or French physical therapy. This is a followup report of gait characteristics at age 5 years in patients who had previously been tested at age 2 years. One hundred-twenty five clubfeet in 90 patients (34 feet only Ponseti treatment, 40 only French PT, and 51 feet initial nonoperative treatment followed by surgery) were included. The gait characteristics were compared to those of age-matched normal control subjects. Ankle equinus during gait occurred in 5% of feet treated with the French method and none of those treated by the Ponseti method. Increased stance phase ankle dorsiflexion persisted in 24% of feet treated by the Ponseti method. Intoeing was seen in 1/3 of both the French and Ponseti methods. Ankle push-off power was decreased compared to normal in patients treated by both methods, and even more so in operated feet. The presence or absence of Achilles tenotomy did not affect ankle power. Gait characteristics of feet that did not have surgery and maintained correction were superior to those of operated feet.

Original languageEnglish (US)
Pages (from-to)1206-1213
Number of pages8
JournalClinical orthopaedics and related research
Volume467
Issue number5
DOIs
StatePublished - May 2009

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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