Plantar contact stress and gait analysis after resection of tarsal coalition


Published online: Oct 27 2009

Adrian Skwara, Vassiliki Zounta, Carsten O. Tibesku, Susanne Fuchs-Winkelmann, Dieter Rosenbaum

From the University Hospital Marburg, Germany

Abstract

The purpose of this study was to assess the foot loading characteristics and foot function of patients after operative correction of a tarsal coalition. Ten patients who had undergone operative treatment of a tarsal coalition were included in this study. One foot was affected in five patients and both feet in the other five. A calcaneonavicular coalition was present in 12 feet and a talocalcaneal coalition in three feet. Mean follow-up was 11.3 years. Clinical evaluation was based on a standardized questionnaire, a visual analogue scale for pain (VAS), the American Orthopaedic Foot and Ankle Society (AOFAS) Score and radiographic evaluation of the last radiographs. An objective analysis of foot loading characteristics was carried out with instrumented gait analysis and pedobarography. The clinical results were overall fair for pain, range of motion and walking distance. The AOFAS also showed fair results (mean : 78.1) at follow-up. Gait analysis revealed alterations in kinematic and kinetic parameters for the operated foot. Pedobarographic analysis showed altered loadings for heel and forefoot. In this study, operative treatment of tarsal coalition achieved fair clinical and radiographic results and did not restore physiologic gait and foot loading.