Functional Assessment of the Foot Undergoing Percutaneous Achilles Tenotomy in Term of Gait Analysis

Abstract

Background. This study was designed to evaluate the function of the foot undergoing the procedure of percutaneous Achilles tenotomy (PAT) in case of clubfoot management in terms of gait analysis. Methods. Nineteen patients with unilateral clubfeet were retrospectively reviewed from our database from July 2012 to June 2016. The result in all the cases was rated as excellent according to the scale of International Clubfoot Study Group (ICSG). The affected sides were taken as Group CF and the contralateral sides as Group CL. Three-dimensional gait analysis was applied for the functional evaluation of the involved foot. Results. Statistical difference was found in physical parameters of passive ankle dorsiflexion and plantar-flexion. No statistical difference was found in temporal-spatial parameters. There was statistical difference in kinematic parameters of total ankle rotation, ankle range of motion, and internal foot progression angle and in kinetic parameters of peak ankle power. No statistical difference was found in other kinematic and kinetic parameters. Conclusions. It is demonstrated that the procedure of PAT is safe and efficient for correcting the equinus deformity in case of clubfoot management and preserving the main function of Achilles tendon at the minimum of four-year follow-up.

Figure 1

Averaged ankle range of motion in sagittal plane for Group CF (red) and Group CL (blue) over one complete gait cycle was compared. Positive values represent dorsiflexion, and negative values represent plantar flexion. Decreased plantar flexion at initial swing phase (toe off phase) was found for both Group CF and Group CL.

Figure 2

Averaged ankle power in sagittal plane for Group CF (red) and Group CL (blue) over one complete gait cycle was compared. Positive values are power generation (Gen) and negative values are power absorption (Abs). Ankle power at push-off phase was significantly decreased for Group CF in comparison with that for Group CL.