Diagnostic Availability of Pedobarography and Correlation of Radiographic and Pedobarographic Measurements in Pediatric Flexible Flatfoot

Young-Jun Seol; Sung-Taek Jung; Hyun-Kee Yang; Keun-Bae Lee; Chang-Seon Oh; Young-Ju Jung; Hang-Nan Cho

doi:10.4055/jkoa.2014.49.5.366

Journal List > J Korean Orthop Assoc > v.49(5) > 1013323

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Seol, Jung, Yang, Lee, Oh, Jung, and Cho: Diagnostic Availability of Pedobarography and Correlation of Radiographic and Pedobarographic Measurements in Pediatric Flexible Flatfoot

Original Article

Journal of the Korean Orthopaedic Association 2014; 49(5): 366-373.

Published online: 30 October 2014

DOI: https://doi.org/10.4055/jkoa.2014.49.5.366

Diagnostic Availability of Pedobarography and Correlation of Radiographic and Pedobarographic Measurements in Pediatric Flexible Flatfoot

Young-Jun Seol, M.D., Sung-Taek Jung, M.D., Hyun-Kee Yang, M.D., Keun-Bae Lee, M.D., Chang-Seon Oh, M.D., Young-Ju Jung, M.D., Hang-Nan Cho, M.D.

Department of Orthopaedic Surgery, Chonnam National University Medical School, Gwangju, Korea.

Correspondence to: Sung-Taek Jung, M.D. Department of Orthopaedic Surgery, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 501-757, Korea. TEL: +82-62-227-1640, FAX: +82-62-225-7794, stjung@chonnam.ac.kr

Received 14 August 2013 Revised 11 February 2014 Accepted 25 June 2014

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to analyze the diagnostic availability and to examine the co-relation between pedobaragraphy and radiography of pediatric flexible flatfoot.

Materials and Methods

Seventeen patients and ten normal children were studied. In radiographic evaluation, the talo-1st metatarsal angle was measured on anteroposterior radiographs; and the talo-1st metatarsal angle, the talo-horizontal angle, the calcaneal pitch, and the talocalcaneal angle were measured on lateral radiographs. In pedobarography, foot pressures were subdivided into eight areas for measurement of contact time, ratio of measured area and to investigate the relation between the degree of the medial deviation of the Center of pressure line and the radiographic measurements.

Results

Flat foot group and normal group showed statistically significant difference in every angle measured in lateral radiographs. The foot pressure ratios of the lateral sides in forefoot and the medial and lateral sides of midfoot and the medial side of hindfoot between the flexible flatfoot group and normal group showed statistically significant difference in pedobarography and ratio of contact area in forefoot and hindfoot showed significant change in statistics but no changes in contact time. The relation between pedobarography and radiography was investigated: foot pressure of the medial and lateral side of forefoot and the talocalcaneal angle showed significant relation in statistics and foot pressure of the medial and lateral side of mid foot and every angle measured in lateral radiographs showed significant relation in statistics. Contact time of midfoot and every radiographic value measured in lateral radiograph showed significant relation in statistics and contact area of forefoot and midfoot showed significant relation with every radiographic value measured in lateral radiographs. In addition, medial deviation of center of pressure line showed significant relation in statistics with talus-first metatarsal angle measured on anteroposterior radiographs and talo-horizontal angle and talus-first metatarsal angle measured on lateral radiographs.

Conclusion

The results of this study showed correlation between radiologic methods and pedobarography in diagnosis of pediatric flexible flatfoot and pedobarography is an useful tool in quantitative and qualitative analysis of the degree of foot deformity and medial deviation of center of pressure line.

Keywords: flexible flatfoot, pedobarography, radiography

Figures and Tables

Figure 1

Radiographic indices in a flatfoot. (A) Anteroposterior view: talo-1st metatarsal angle. (B) Lateral view: talo-1st metatarsal angle. (C) Lateral view: calcaneal pitch. (D) Lateral view: talocalcaneal angle. (E) Lateral view: talo-horizontal angle.

Figure 2

Pedobarographic result. (A) Foot pressure data. (B) Contact time data. (C) Contact area data. ROP, roll of process.

Figure 3

Anteroposterior index (B/A) and center of pressure excursion index (D/C). A, anteroposterior length of the foot; B, anteroposterior length of the path of the center of pressure; C, maximum width of the foot; D, lateral deviation of the center of pressure from the construction.

Table 1

Radiographic Measurement

Values are presented as median (range). Independent t-test was used. ^*Normal range of radiologic measurement is from Duk Yong Lee's Pediatric orthopaedics, 3rd edition. ^†Statistically significant.

Table 2

Comparison of Pedobarographic Results between Flatfoot and Normal Foot

Independent t-test was used.

Table 3

Association between Pedobarographic Measurement and Radiographic Measurement of Flatfeet in Children

Bivariate correlation analysis was used. *Statistically significant.

Table 4

Association between Center of Pressure and Radiographic Measurement

Bivariate correlation analysis was used. *Statistically significant. p, the significance level.

References

1. Ananthakrisnan D, Ching R, Tencer A, Hansen ST Jr, Sangeorzan BJ. Subluxation of the talocalcaneal joint in adults who have symptomatic flatfoot. J Bone Joint Surg Am. 1999; 81:1147–1154.

2. Brooks MH. Flat feet in children. BMJ. 1991; 302:237.

3. Han SH, Jung M, Lee JW. Pedobarographic analysis in functional foot orthosis. J Korean Foot Ankle Soc. 2006; 10:125–132.

4. Mickle KJ, Steele JR, Munro BJ. Is the foot structure of preschool children moderated by gender? J Pediatr Orthop. 2008; 28:593–596.

5. Jameson EG, Davids JR, Anderson JP, Davis RB 3rd, Blackhurst DW, Christopher LM. Dynamic pedobarography for children: use of the center of pressure progression. J Pediatr Orthop. 2008; 28:254–258.

6. Harris EJ, Vanore JV, Thomas JL, et al. Diagnosis and treatment of pediatric flatfoot. J Foot Ankle Surg. 2004; 43:341–373.

7. Pauk J, Daunoraviciene K, Ihnatouski M, Griskevicius J, Raso JV. Analysis of the plantar pressure distribution in children with foot deformities. Acta Bioeng Biomech. 2010; 12:29–34.

8. Park ES, Kim HW, Park CI, Rha DW, Park CW. Dynamic foot pressure measurements for assessing foot deformity in persons with spastic cerebral palsy. Arch Phys Med Rehabil. 2006; 87:703–709.

9. Alvarez C, De Vera M, Chhina H, Black A. Normative data for the dynamic pedobarographic profiles of children. Gait Posture. 2008; 28:309–315.

10. Oeffinger DJ, Pectol RW Jr, Tylkowski CM. Foot pressure and radiographic outcome measures of lateral column lengthening for pes planovalgus deformity. Gait Posture. 2000; 12:189–195.

11. Bae HS, Park CI, Shin JC, Park JW. The changes of plantar pressure and pathway of center of pressure in foot during the gait in normal preschool children with age. J Korean Acad Rehabil Med. 2001; 25:1041–1047.

12. Moon HW, Park SI, Rah UW, Lee IY, Yim SY, Kim JH. Foot pressure measurement using F-scan system in normal Korean adults. J Korean Acad Rehabil Med. 1995; 19:289–295.

13. Kadhim M, Holmes L Jr, Miller F. Correlation of radiographic and pedobarograph measurements in planovalgus foot deformity. Gait Posture. 2012; 36:177–181.

TOOLS

Similar articles