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Combined 3D analysis of lower-limb morphology and function in children with idiopathic equinovarus clubfoot: A preliminary study

Article dans une revue avec comité de lecture
Author
RAMPAL, Virginie
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]
ROHAN, Pierre-Yves
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]
PILLET, Hélène
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]
BONNET-LEBRUN, Aurore
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]
FONESCA, Mickael
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]
DESAILLY, Eric
466939 Unité Clinique d’Analyse de la Marche du Mouvement
WICART, Philippe
414766 CHU Necker - Enfants Malades [AP-HP]
SKALLI, Wafa
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]

URI
http://hdl.handle.net/10985/19571
DOI
10.1016/j.otsr.2019.11.013
Date
2020
Journal
Revue de Chirurgie Orthopédique et Traumatologique

Abstract

Introduction In children treated for idiopathic equinovarus clubfoot (EVCF), the relation between morphologic defects on clinical examination and standard X-ray on the one hand and functional abnormalities on the other is difficult to objectify. The aim of the present study was to demonstrate the feasibility of combined 3D analysis of the foot and lower limb based on biplanar EOS radiographs and gait analysis. The study hypothesis was that this provides better understanding of abnormalities in form and function. Methods Ten children with unilateral EVCF and “very good” clinical results were included. They underwent gait analysis on the Rizzoli Institute multisegment foot model. Kinematic data were collected for the hip, knee, ankle and foot (hindfoot/midfoot, midfoot/forefoot and hindfoot/forefoot). Biplanar EOS radiographs were taken to determine anatomic landmarks and radiological parameters. Results Complete acquisition time was around 2 hours per patient. No significant differences were found between EVCF and healthy feet except for calcaneal incidence, tibiocalcaneal angle and hindfoot/midfoot and hindfoot/forefoot inversion. Discussion The feasibility of the combined analysis was confirmed. There were no differences in range of motion, moment or power between EVCF and healthy feet in this series of patients with very good results. The functional results are related to radiological results within the normal range. The protocol provided anatomic and kinematic reference data. A larger-scale study could more objectively assess the contribution of EOS radiography using optoelectronic markers. Level of evidence II, low-power prospective study.

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