Foot pressure in clubfoot: The development of an objective assessment tool

Background: There are no universal criteria for the assessment of clubfoot. The ideal method should assess functional deformity reliably and objectively. Biomechanical techniques have also been suggested but their role remains undefined. Objective: This study aimed to assess surgically corrected clubfeet by biomechanical means with the intention to develop certain ratios to aid in objective assessment. Methods: Thirteen children (16 feet) with idiopathic clubfoot, who had previously undergone surgery (lateral-posteromedial release), were reviewed. Various clinical measurements were collected and symptoms assessed using a specially designed questionnaire. Biomechanical (foot pressure) parameters were obtained using two systems: Podotrack and Dynamic Pedobarograph. Results: The results showed that foot pressure data were able to demonstrate abnormalities in foot posture and pressure distribution, which could objectively identify clubfoot deformities. In particular, ratios were calculated, which could be used to determine severity and monitor progression. Conclusion: This study suggests that foot pressure analysis should be routinely used in the assessment of clubfoot. The ratios calculated would be of immense help to the clinicians in monitoring the success of treatment and for early prediction of relapse in patients treated for clubfoot.