An evaluation of surgical functional reconstruction of the foot using kinetic and kinematic systems: a case report

Most pedobarographic studies of microsurgical foot reconstruction have been retrospective. In the present study, we report the results from a prospective pedobarographic study of a patient after microsurgical reconstruction of her foot with a latissimus dorsi flap and a cutaneous paddle, with a 42-month follow-up period. We describe the foot reconstruction plan and the pedobarographic measurements and analyzed its functional outcome. The goal of the present study was to demonstrate that pedobarography could have a role in the treatment of foot reconstruction from a quantitative perspective. The pedobarographic measurements were recorded after the initial coverage surgery and 2 subsequent foot remodeling procedures. A total of 4 pedobarographic measurements and 2 gait analyses were recorded and compared for both the noninvolved foot and the injured foot. Furthermore, the progress of the reconstructed foot was critically evaluated using this method. Both static and dynamic patterns were compared at subsequent follow-up visits after the foot reconstruction. The values and progression of the foot shape, peak foot pressure (kPa), average foot pressure (kPa), total contact surface (cm2), loading time (%), and step time (ms) were recorded. Initially, the pressure distribution of the reconstructed foot showed higher peak values at nonanatomic locations, revealing a greater ulceration risk. Over time, we found an improvement in the shape and values of these factors in the involved foot. To homogenize the pressure distribution and correct the imbalance between the 2 feet, patient-specific insoles were designed and fabricated. In our patient, pedobarography provided an objective, repeatable, and recordable method for the evaluation of the reconstructed foot. Pedobarography can therefore provide valuable insights into the prevention of pressure ulcers and optimization of rehabilitation

Relationship of Lunge and Jack test in calcaneal apophysitis (sever´s disease) in young soccer players

La talalgia de Sever o apofisitis calcánea ocurre generalmente antes o durante el pico de crecimiento acelerado en niños y niñas. En ocasiones se presenta al practicar un nuevo deporte que implique desplazamientos y saltos como el fútbol. Fue descrita por el Doctor J. W. Sever, a causa de la detección de un dolor con sensibilidad localizada en la cara posterior del hueso calcáneo en jóvenes. El objetivo de este estudio es relacionar la incidencia de la talalgia de Sever con la restricción en los valores del Lunge test y con la incapacidad para activar el mecanismo de Windlass medido a través del test de Jack. Se realizaron los dos test a una muestra de 60 futbolistas jóvenes divididos en dos grupos (Sever = 30 jóvenes, de 10,84±0,79 años y 16,87±0,85 de IMC; No Sever = 30 jóvenes, de 10,87±0,80 y 17,58±1,41 de IMC). Los resultados muestran un test de Jack del pie derecho positivo en el 26,7% de los niños con Sever frente al 10,0% de los niños sin Sever (p=0,181). Mientras que, para el pie izquierdo, el 33,3% de los niños con Sever tiene el test de Jack positivo frente al 13,3% de los niños sin Sever (p=0,125). Por otro lado, el Lunge test para el pie derecho muestra una diferencia significativa.Sever´s Disease or calcaneal apophysitis occur before or during the early growth in children. Experienced after a new practice of psychical activity that involve running or jumping as soccer. It was described by Dr. J. W. Sever, due to detection of pain with localized sensitivity in the posterior area of the calcaneus bone in young people. The aim of the study is relate the Sever´s Disease incidence and restricted values of Lunge test. In the same way, the inability to activate the windlass mechanism measured through the Jack test related with Sever´s Disease incidence. We performed both test to 60 young soccer players divided in two groups (Sever = 30 young players, 10,84±0,79 years old and 16,87±0,85 IMC values; No Sever = 30 young players, 10,87±0,80 years old and y 17,58±1,41 IMC values). The results shows that a 26,7% of Sever´s Disease patient had a positive Jack test in right foot versus 10,0% of non Sever´s Disease patient (p=0,181). While for left foot, a 33,3% of Sever´s Disease patient had a positive Jack test versus 13,3% of non Sever´s Disease patient (p=0,125). On the other hand, Lunge test for right foot show a significant difference (p<0,01).Sin financiaciónNo data JCR 2017No data SJR 2017No data IDR 2017UE

Effectiveness of Custom-Made Foot Orthoses vs. Heel-Lifts in Children with Calcaneal Apophysitis (Sever’s Disease): A CONSORT-Compliant Randomized Trial

The aim of the present research was to determine the effectiveness of relieving calcaneal apophysitis pain using “off-the-shelf” heel-lifts and custom-made orthotics. Two intervention modalities were evaluated and compared in a 12-week follow-up trial. Inclusion criteria included 9- to 12-year-old children diagnosed with calcaneal apophysitis. Children were randomly stratified into treatment A (custom-made polypropylene foot orthoses) and treatment B (“off-the-shelf” heel-lifts) groups. Treatment effectiveness was measured by algometry and the visual analogical scale (VAS). A total of 208 patients were included. The treatment A group showed an increase in threshold algometry of 53.4% (95% CI 47.1% to 59.7%) and a decrease in VAS of −68.6% (95% CI −74.5% to −62.7%) compared with the treatment B group (p &lt; 0.001). Calcaneal apophysitis pain perception was improved in both groups, but children who used custom-made foot orthoses showed a greater improvement