Article

The Bridle procedure restores active ankle dorsiflexion through a tri-tendon anastomosis of the tibialis posterior, transferred to the dorsum of
the foot, with the peroneus longus and tibialis anterior tendon. Inter-segmental
foot motion after the Bridle procedure has not been measured. The purpose of this
study is to report kinetic and kinematic variables during walking and heel rise
in patients after the Bridle procedure. METHODS:
18 Bridle and 10 control
participants were studied. Walking and heel rise kinetic and kinematic variables
were collected and compared using an ANOVA. FINDINGS: During walking the Bridle
group, compared with controls, had reduced ankle power at push-off [2.3 (SD 0.7)
W/kg, 3.4 (SD 0.6) W/kg, respectively, P<.01], less hallux extension during swing
[-13 (SD 7) degrees , 15 (SD 6) degrees , respectively, P<.01] and slightly less
ankle dorsiflexion during swing [6 (SD 4) degrees , 9 (SD 2) degrees ,
respectively, P=.03]. During heel rise the Bridle group had 4 (SD 6) degrees of
forefoot on hindfoot dorsiflexion compared to 8 (SD 3) degrees of plantarflexion
in the controls (P<.01). INTERPRETATION: This study provides evidence that the
Bridle procedure restores the majority of dorsiflexion motion during swing.
However, plantarflexor function during push-off and hallux extension during swing
were reduced during walking in the Bridle group. Abnormal mid-tarsal joint
motion, forefoot on hindfoot dorsiflexion instead of plantarflexion, was
identified in the Bridle group during the more challenging heel rise task.
Intervention after the Bridle procedure must maximize ankle plantarflexor
function and midfoot motion should be examined during challenging tasks.
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Langue : ANGLAIS