Article

Pes planovalgus (flatfoot) is a common deformity among children with cerebral
palsy. The Milwaukee Foot Model (MFM), a multi-segmental kinematic foot model,
which uses radiography to align the underlying bony anatomy with reflective
surface markers, was used to evaluate 20 pediatric participants (30feet) with
planovalgus secondary to cerebral palsy prior to surgery. Three-dimensional
kinematics of the tibia, hindfoot, forefoot, and hallux segments are reported and
compared to an age-matched control set of typically-developing children. Most
results were consistent with known characteristics of the deformity and showed
decreased plantar flexion of the forefoot relative to hindfoot, increased
forefoot abduction, and decreased ranges of motion during push-off in the
planovalgus group. Interestingly, while forefoot characteristics were uniformly
distributed in a common direction in the transverse plane, there was marked
variability of forefoot and hindfoot coronal plane and hindfoot transverse plane
positioning. The key finding of these data was the radiographic indexing of the
MFM was able to show flat feet in cerebral palsy do not always demonstrate more
hindfoot eversion than the typically-developing hindfoot. The coronal plane
kinematics of the hindfoot show cases planovalgus feet with the hindfoot in
inversion, eversion, and neutral. Along with other metrics, the MFM can be a
valuable tool for monitoring kinematic deformity, facilitating clinical decision
making, and providing a quantitative analysis of surgical effects on the
planovalgus foot.
CI - Copyright (c) 2017 Elsevier B.V. All rights reserved.

Langue : ANGLAIS