Clinicoradiographic Assessment of Flexible Flatfoot in Children

2010 ◽  
Vol 100 (6) ◽  
pp. 463-471 ◽  
Author(s):  
Maria Grazia Benedetti ◽  
Lisa Berti ◽  
Sofia Straudi ◽  
Francesco Ceccarelli ◽  
Sandro Giannini
Keyword(s):  
Daily Living ◽  
Functional Limitation ◽  
Standing Position ◽  
Valgus Deformity ◽  
Lateral View ◽  
Heel Pain ◽  
Clinical Parameters ◽  
Radiographic Assessment ◽  
Radiographic Measurements ◽  
Flexible Flatfoot

Background: Radiographic assessment is still used to evaluate flexible flatfoot in children. Methods: To find a set of radiologic parameters for assessing this disease, we studied 53 children aged 10 to 14 years. The degree of plantar collapse was measured by Viladot’s classification (grades 0–4). The degree of valgus deformity measured in the heel in a standing position, the presence of painful points, and functional limitation during daily-living activities were also reported. The children underwent standard radiography of the foot under load. On the dorsoplantar view, the talocalcaneal, hallux metatarsophalangeal, and first intermetatarsal angles were measured. On the lateral view, the talocalcaneal, Costa Bertani, talometatarsal, talonavicular, and tibiotalar angles were measured. The radiographic measurements were compared with the data reported in the literature and were correlated with the clinical parameters studied (degree of flatfoot, valgus deviation of the heel, pain, and functional limitation). Results: The radiographic measures that resulted increased with respect to the reference values reported in the literature for the Costa Bertani (93.1% of feet), talometatarsal (93.5%), talonavicular (89.1%), and tibiotalar (69.7%) angles, all in the lateral view. Of the angles assessed in the dorsoplantar view, the hallux metatarsophalangeal (11.1%) and first intermetatarsal (24.2%) angles were increased. The degree of flatfoot was correlated with the Costa Bertani angle (P < .0005). In the group with pain, the lateral talocalcaneal (P = .016) and first intermetatarsal (P = .02) angles were increased compared within the group without pain. Conclusions: Despite technical limitations, we still consider standard radiography of the foot, combined with clinical examination, to be a valid tool for assessing flexible flatfoot in children, especially when surgical treatment is expected and when a basic measure of the structural setup of the foot is necessary. (J Am Podiatr Med Assoc 100(6): 463–471, 2010)

scholarly journals Long-Term Outcomes of the Calcaneo-Stop Procedure in the Treatment of Flexible Flatfoot in Children: A Retrospective Study

2017 ◽  
Vol 30 (7-8) ◽  
pp. 541 ◽  
Author(s):  
Francisca Pinho Costa ◽  
Gilberto Costa ◽  
Manuel Santos Carvalho ◽  
António Mendes Moura ◽  
Rui Pinto ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Daily Living ◽  
Clinical Parameters ◽  
Foot And Ankle ◽  
Long Term Outcomes ◽  
Short Term ◽  
Flexible Flatfoot ◽  
Related Quality

Introduction: Flexible flatfoot is common amongst children, although treatment is rarely indicated. The calcaneo-stop procedure has been reported to be effective in short-term studies. We aim to evaluate the long-term outcomes of the calcaneo-stop procedure in the treatment of flexible flatfoot in children.Material and Methods: Twenty-six calcaneo-stop procedures performed between 1995 and 2006 on 13 patients were evaluated clinically and using photopodoscopy, and the FAOS questionnaire was applied for both feet.Results: Of the 26 feet evaluated, 22 presented with heel valgus, 13 had forefoot supination and 11 had abnormal footprints. Median FAOS questionnaire score was 97.22 for ‘Pain’, 92.86 for ‘Other symptoms’, 98.53 for ‘Function in daily living’, 100 for ‘Function in sports and recreation’ and 93.75 for ‘Foot and ankle-related quality of life’.Discussion: The calcaneo-stop procedure is the least invasive and most simple surgical treatment for symptomatic flexible flatfoot in children. Short-term studies report excellent clinical and radiographic results. The authors report alterations in clinical parameters in a large proportion of patients. These findings can be due to biomechanical alterations in the years following removal of the screw. Patient foot and ankle-related satisfaction data is promising, although hard to evaluate given the absence of preoperative data.Conclusion: Larger, prospective, controlled studies are required to better evaluate the long-term success of this procedure.

scholarly journals Social integration and its relationship with functional limitations in Chilean older adults

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L de Albuquerque Araújo ◽  
G Icaza Noguera ◽  
C Albala Brevis
Keyword(s):  
Older Adults ◽  
Social Integration ◽  
Daily Living ◽  
Protective Factor ◽  
Public Policies ◽  
Functional Limitations ◽  
Functional Limitation ◽  
Lower Prevalence ◽  
Community Groups ◽  
Recreational Activities

Abstract We are experiencing the highest levels of life expectancy and it poses challenges in the maintenance of the functional capacity in old age. This study seeks to determine the relation between social integration and functional limitation in Chilean older adults. Cross-sectional study with baseline of two cohort studies: the SABE cohort (born before 1940) and the Alexandros cohort (born between 1940 and 1948 from Primary Health Care centers), from Santiago. Were considered 1733 elderly. Performance variables were studied in seven Instrumental Activity of Daily Living (IADL): preparing food, managing money, leaving home alone, making purchases, making or receiving calls, doing light housework, organizing and taking medications, and six basic Activities of Daily Living (ADL): bathing, dressing, use of the bathroom, transfer, continence of urine and feeding. Having difficulties or inability to perform at least one activity was classified as having functional limitations. Social integration variables were: participation in community groups, clubs or organizations and in recreational activities. Adjustment variables were: sex, age, educational level, household income, depression, cognitive impairment and multimorbidity. Robust Poisson Regression was performed and prevalence ratios (PR) of functional limitation in ADL and IADL were reported. The level of significance was ≤0.5. Prevalence of functional limitations in ADL was 73.3% and in AIVD was 37.1%. Who participated in recreational activities have a lower prevalence of functional limitation in ADL (PR 0.85; 95%CI 0.80-0.90) and in IADL (PR 0.74; 95% CI0.63-0.86). Participation in community groups, clubs or organizations was associated with a lower prevalence of limitation in ADL (RP 0.78; 95%CI 0.71-0.87), although it was not significantly related to performance in IADL. Greater social integration in adulthood is a protective factor for limitation in ADL and IADL and should be the subject of public policies in Chile. Key messages Social integration seems to be a protective factor for functional limitation in Chilean older adults. Society and public policies should give greater opportunity for the elderly to participate in recreational activities and community groups.

Radiographic Assessment of the Robert and Lateral Views in Trapeziometacarpal Osteoarthrosis

Hand Surgery ◽  
2015 ◽  
Vol 20 (02) ◽  
pp. 251-259 ◽  
Author(s):  
Jonathan Oheb ◽  
Yuri Lansinger ◽  
Joshua A. Jansen ◽  
Jimmy Q. Nguyen ◽  
Margaret A. Porembski ◽  
...  
Keyword(s):  
Disease Severity ◽  
Joint Pain ◽  
Interrater Reliability ◽  
Lateral View ◽  
X Rays ◽  
Radiographic Assessment ◽  
Patient Demographics ◽  
Radiographic Disease ◽  
Stage 1 ◽  
Subchondral Sclerosis

Background: To evaluate the effectiveness of the Robert view in assessing trapeziometacarpal arthrosis and to compare the accuracy of the Robert and lateral views in staging trapeziometacarpal (TM) joint arthrosis. Methods: Patient demographics were obtained. Four participating raters reviewed 62 randomly selected thumb x-rays of patients presenting with thumb TM joint pain. Lateral and Robert-hyperpronation views were assessed using an analysis of 13 criteria. Results: X-rays of 62 thumbs for 58 patients were evaluated. The average patients' age was 64 (47-87) and 51 (80%) were females. The majority of X-rays evaluated fell into stage 3. Stage 2 was the second most common level of arthritis encountered and the least was stage 1. More osteophytes were encountered in the trapezium than metacarpal on both the Robert and lateral views. The Robert view was superior in detecting osteophytes on the trapezium than the lateral view. Osteophyte size varied from 1.7 to 2 mm. The lateral view displayed 61 cases with dorsal metacarpal subluxation (98%). The Robert view displayed 48 cases (77%) with radial metacarpal subluxation and 9 cases (15%) with ulnar metacarpal subluxation. Thumb metacarpal adduction deformity was encountered on the lateral view in 20 cases (32%) whereas on the Robert view it was encountered in 14 cases (23%). Subchondral sclerosis was encountered on the Robert view in 56 thumbs (90%) while it was seen on the lateral view in 52 thumbs (84%). Pantrapezial arthritis involving the STT joint was encountered equally in 16 cases (26%) on the Robert view and the lateral views. The study found a moderate level of interrater reliability on both the lateral and Robert views. With the exception of osteophytes encountered on the trapezium versus the metacarpal, there were no other statistically significant findings. Conclusions: This study confirms that each of the Robert and lateral views offer unique information and combining both views enhances the ability to assess radiographic disease severity, and should be the recommended set of X-rays for assessing TM osteoarthrosis.

The Effects of Talus Control Foot Orthoses in Children with Flexible Flatfoot

2017 ◽  
Vol 107 (1) ◽  
pp. 46-53 ◽  
Author(s):  
So Young Ahn ◽  
Soo Kyung Bok ◽  
Bong Ok Kim ◽  
In Sik Park
Keyword(s):  
Therapeutic Effect ◽  
Foot Orthoses ◽  
Talonavicular Joint ◽  
Radiographic Measurements ◽  
Flexible Flatfoot ◽  
Foot Orthosis

Background: A talus control foot orthosis (TCFO) combines an inverted rigid foot orthosis (RFO) with a broad upright portion that rises well above the navicular to cover and protect the talonavicular joint. We sought to identify the therapeutic effect of TCFOs in children with flexible flatfoot. Methods: Flexible flatfoot was diagnosed in 40 children when either of the feet had greater than 4° valgus of resting calcaneal stance position (RCSP) angle and one of the radiographic indicators was greater than 30° in anteroposterior talocalcaneal angles, 45° in lateral talocalcaneal angles, and 4° in lateral talometatarsal angles and less than 10° of calcaneal pitch in barefoot radiographs. Of 40 children with flexible flatfoot, 20 were fitted with a pair of RFOs and 20 with TCFOs, randomly. Follow-up clinical and radiographic measurements were completed 12 months later. Results: All of the radiographic indicators changed toward the corrective direction in both groups. There were significant improvements in calcaneal pitch and RCSP in both groups (P < .05). In the TCFO group, the anteroposterior talocalcaneal angle and the RCSP showed statistically significant improvement compared with the RFO group. Conclusions: In this study, the TCFO was more effective than the RFO at treating children with flexible flatfoot.

scholarly journals Functional limitation on elderly people in the northeast and the feminization of eld in urban and rural areas of Brazil

2021 ◽  
Vol 43 ◽  
pp. e51421
Author(s):  
Roberta Dayanny Soares ◽  
Aíla Maropô Araújo
Keyword(s):  
Activities Of Daily Living ◽  
Rural Areas ◽  
Urban Areas ◽  
Daily Living ◽  
Functional Limitation ◽  
Rio Grande ◽  
The Elderly ◽  
Northeast Region ◽  
Instrumental Activities ◽  
Urban And Rural Areas

Population aging in Brazil increases on a large scale due to declining fertility and mortality. This phenomenon can be influenced by several factors (demographic, biological and social), making them determinants for the health conditions of the elderly populations residing in different geographic areas. The present study aims to identify the functional limitation in elderly residents of urban and rural areas of Brazil. This is a descriptive epidemiological study with a quantitative approach. It was evidenced that the functional limitation for activities of daily living   and instrumental activities of daily living are concentrated in the northeast region, mainly in the urban area. The following states presented the highest proportions of daily life activity limitation in urban areas: Alagoas (11.60%), Rio Grande do Norte (10.95%), Pernambuco (10.36%) and Paraíba (9.62%). For activities of daily living in the rural area were found in the states of Paraíba (12.19%), Maranhão (8.93%), Piauí (8.85%) and then Pernambuco (7.24%). Data from the functional limitation for instrumental activities of daily living again highlighted the Northeast region, with the states of Rio Grande do Norte (26.01%), Paraíba (25.96%), Maranhão (25.72%) and Alagoas (24.57%). Lastly, it was verified that the elderly woman exhibits greater proportions of functional limitation in relation to the elderly of the masculine sex, standing out again the northeastern region of the country.

Incidence of plantar fasciitis in overweight patients of government hospitals of Faisalabad city.

2021 ◽  
Vol 28 (05) ◽  
pp. 718-724
Author(s):  
Ali Raza ◽  
Shahroz Saleem ◽  
Hafiz Salman Saeed ◽  
Ahmad Bilal ◽  
Zafar Ali Zafar ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Plantar Fasciitis ◽  
Heel Pain ◽  
Significant Relation ◽  
Chi Square ◽  
Plantar Heel Pain ◽  
Government Hospitals ◽  
Chi Square Test

Objective: To determine relationships of body mass index with plantar fasciitis and foot functions index and how many activities of daily living were limited with plantar heel pain due to overweight in population of Government Hospitals of Faisalabad City. Study Design: Cross-sectional study. Setting: Government Hospitals of Faisalabad City (Allied Hospital & District Headquarter Hospital). Period: March to May 2018. Material & Methods: 140 patients included both males and females. Convenient sampling technique was used in selection of study sample. Calculate BMI (kg/m2) and FFI questionnaire used in this study to find how many activities of daily living was limited with plantar heel pain due to overweight. Data was analyzed by using statistical package for social sciences (SPSS) version 20. Chi square test was applied. Results: There were 70 males and 70 females. Data was collected to overweight population (mean age, 42.15; mean BMI, 29.52 kg/m2; and mean height, 1.68m). Out of 140 overweight population was (66.4%) and obese population (33.6%). The windlass test showed (87.9%) positive and (12.1%) negative. Chi-square test revealed no significant relation between rise in BMI and plantar heel pain (p = 0.105). However it shows significant relation between rise in BMI and FFI (p = 0.000). Conclusion: There is no statistical significant relation between body mass index and plantar fasciitis. According to foot function index patients significantly limit activities of daily living with plantar heel pain due to overweight.

scholarly journals Body Weight Effects on Extra-Osseous Subtalar Arthroereisis

2019 ◽  
Vol 8 (9) ◽  
pp. 1273 ◽  
Author(s):  
Chiun-Hua Hsieh ◽  
Chia-Che Lee ◽  
Tzu-Hao Tseng ◽  
Kuan-Wen Wu ◽  
Jia-Feng Chang ◽  
...  
Keyword(s):  
Body Weight ◽  
Lateral View ◽  
The Body ◽  
Posterior View ◽  
Flexible Flatfoot ◽  
Subtalar Arthroereisis ◽  
Overweight Group ◽  
Anterior Posterior

Implant extrusion in subtalar arthroereisis is a common complication for pediatric flexible flatfoot. However, there were a limited number of articles addressing the body weight effects on implant extrusion after the procedure. We conducted a 24-month follow-up assessment after subtalar arthroereisis. Surgical patients who underwent the Vulpius procedure were retrospectively collected from May 2010 to January 2017, including 59 cases of both feet having implants in situ and 43 cases of both feet having implant extrusion. The average age of 102 patients was 9 years old. The mean body mass index (BMI) of the implant in situ group was 19.5, whilst the extrusion group was 21.2 (p = 0.035). The inter-observer correlation was excellent. There were 11 cases (39.3%) of bilateral extrusion in the overweight group (BMI ≥ 24) and 13 cases (23.2%) in the low body weight group (BMI ≤ 18.5) (p < 0.0004). Postoperative radiographic angles were corrected in both the implant in situ group and the extrusion group. Nonetheless, the implant in situ group revealed better postoperative outcomes of Meary’s angle and the talonavicular angle from an anterior-posterior view, and the talar inclination angle from a lateral view. We conclude that a higher BMI is related to implant extrusion and worse results after subtalar arthroereisis. Further prospective study to investigate whether preoperative weight loss results in improved surgical outcomes is warranted in the future.

scholarly journals Dynamic First Tarsometatarsal Instability During Gait Evaluated by Pedobarographic Examination in Patients with Hallux Valgus

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0030
Author(s):  
Byung Jo Min ◽  
Seungbum Koo ◽  
Won-keun Park ◽  
Ki-bum Kwon ◽  
Kyoung Min Lee
Keyword(s):  
Hallux Valgus ◽  
Joint Instability ◽  
Weight Bearing ◽  
Binary Logistic Regression ◽  
Valgus Deformity ◽  
Binary Logistic Regression Analysis ◽  
Tarsometatarsal Joint ◽  
Hallux Valgus Deformity ◽  
Metatarsal Angle ◽  
Radiographic Measurements

Category: Midfoot/Forefoot Introduction/Purpose: This study aimed to investigate the pedobarographic characteristics of tarsometatarsal instability and to identify factors associated with pedobarographic first tarsometatarsal instability in patients with hallux valgus deformity. Methods: Fifty-seven patients (mean age, 59.7 years; standard deviation, 11.4 years; 6 men and 51 women) with a hallux valgus angle (HVA) greater than 15° were included. All patients underwent a pedobarographic examination along with weight-bearing anteroposterior (AP) and lateral foot radiography. Radiographic measurements were compared between the two groups with and without pedobarographic first tarsometatarsal instability. The association between the radiographic and pedobarographic parameters of the first tarsometatarsal instability was analyzed using the chi-square test. Binary logistic regression analysis was performed to identify significant factors affecting pedobarographic first tarsometatarsal instability. Results: HVA (p<0.001), the intermetatarsal angle (p=0.001), and AP talo-first metatarsal angle were significantly different between the pedobarographically stable and unstable tarsometatarsal groups. There was no significant association between radiographic and pedobarographic instabilities of the first tarsometatarsal joint (p=0.924). HVA was found to be the only significant factor affecting pedobarographic tarsometatarsal joint instability (p=0.001). Conclusion: The pedobarographic examination has possible clinical utility in evaluating first tarsometatarsal joint instability in patients with hallux valgus deformity. Patients with greater HVA need to be carefully monitored for the presence of first tarsometatarsal instability, and the necessity of the Lapidus procedure should be considered.

scholarly journals Ultrasound study of the motion of the residual femur within a trans-femoral socket during daily living activities other than gait

2001 ◽  
Vol 25 (3) ◽  
pp. 220-227 ◽  
Author(s):  
P. Convery ◽  
K. D. Murray
Keyword(s):  
Daily Living ◽  
Ultrasound Image ◽  
Standing Position ◽  
Daily Living Activities ◽  
Motion Patterns ◽  
Double Support ◽  
Daily Living Activity ◽  
Ultrasound Study ◽  
Flexion Extension ◽  
The Right

This study analyses the residual femur motion of a single amputee within a trans-femoral socket during a series of daily living activities. Two simultaneously transmitting, socket mounted transducers were connected to two ultrasound scanners. Displacement measurements of the ultrasound image of the femur were video recorded and measured on “paused” playback. Abduction/adduction and flexion/extension of the residual femur within the socket at any instant during these activities were estimated, knowing the relative positions of the two transducers and the position of the residual femur on the ultrasound image. Consistent motion patterns of the residual femur within the trans-femoral socket were noted throughout each monitored daily living activity of the single amputee studied. Convery and Murray (2000) reported that during level walking, relative to the socket, the residual femur extends 6° and abducts 9° by mid-stance while flexing 6° and adducting 2° by toe-off. Uphill/downhill, turning to the right and stepping up/down altered this reported pattern of femoral motion by approximately 1°. During the standing activity from a seated position the femur initially flexed 4° before moving to 7° extension, while simultaneously adducting 6°. During the sitting activity from a standing position the femur moved from 7° extension and 6° adduction to 3° flexion and 1° abduction. The activity of single prosthetic support to double support introduced only minor femoral motion whereas during the activity of prosthetic suspension the femur flexed 8° while simultaneously adducting 9°. Additional studies of more amputees are required to validate the motion patterns presented in this investigation.

Metatarsus adductus and selected radiographic measurements of the first ray in normal feet

1992 ◽  
Vol 82 (12) ◽  
pp. 616-622 ◽  
Author(s):  
TA Griffiths ◽  
SJ Palladino
Keyword(s):  
Normal Values ◽  
Valgus Deformity ◽  
The Other ◽  
Radiographic Evaluation ◽  
Intermetatarsal Angle ◽  
Radiographic Measurements ◽  
First Ray ◽  
Metatarsus Adductus ◽  
Document Relationships

Radiographic evaluation of hallux abducto valgus frequently involves the measurement of the metatarsus adductus angle, first-second intermetatarsal angle, hallux abductus angle, and proximal articular set angle. While the concept that there is a relationship between untreated metatarsus adductus and hallux abducto valgus deformity is not new, a quantifiable relationship between the metatarsus adductus angle and intermetatarsal angle, hallux abductus angle, and the proximal articular set angle in normal feet is relatively undocumented. The purpose of this study is to document relationships between the metatarsus adductus angle and the other three measurements, and to establish normal values for the intermetatarsal angle, hallux abductus angle, and proximal articular set angle within metatarsus adductus angle subgroups.

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