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Abnormalities in the uninvolved foot in children with spastic hemiplegia.
MedLine Citation:
PMID:  22892623     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: : Although the uninvolved foot in patients with hemiplegia has been thought to be normal, we frequently observed valgus deformity of the uninvolved foot among those patients. The purpose of this study was to evaluate by dynamic pedobarograph the prevalence and pattern of foot deformity in the uninvolved limb among children with hemiplegia.
METHODS: : In this study, we included 119 patients with hemiplegia (67 males and 52 females) who underwent gait analysis from 2001 to 2008. The mean age at evaluation was 9.2±3.4 years (range, 5.1 to 19.8 y). Patient demographics, passive range of motion, kinematics, kinetics, and dynamic pedobarographic data were obtained from the medical records. Coronal index [(CI): the impulse percentage under the medial column minus the impulse percentage under the lateral column] was calculated from the pedobarographic data.
RESULTS: : Of 119 feet, 60 feet (50.4%) had a normal CI, whereas 52 feet (43.7%) showed a valgus CI. Only 7 feet (5.9%) had a varus CI. Compared with the patients with a normal CI, patients who had a valgus CI had increased ankle dorsiflexion at initial contact (-0.9±4.1 vs. 0.8±4.7, P=0.048) and knee extension moment (0.6±0.31 vs. 0.73±0.28, P=0.036) of the uninvolved foot. Actual limb-length discrepancy did not differ between the 2 groups (P=0.556).
CONCLUSIONS: : Valgus foot deformity of the uninvolved foot is common among children with hemiplegia. It is associated with increased ankle dorsiflexion and knee extension moments of the uninvolved side. Longer follow-up will be needed to evaluate the effect of the valgus foot deformity of the uninvolved limb on the gait in patients with hemiplegia.
LEVEL OF EVIDENCE: : Level III. Diagnostic.
Sunyoung Joo; Freeman Miller
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric orthopedics     Volume:  32     ISSN:  1539-2570     ISO Abbreviation:  J Pediatr Orthop     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8109053     Medline TA:  J Pediatr Orthop     Country:  United States    
Other Details:
Languages:  eng     Pagination:  605-8     Citation Subset:  IM    
*Department of Orthopedic Surgery, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE †Department of Orthopedic Surgery, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea.
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