Long-term effects of hindfoot fractures evaluated by means of plantar pressure analyses

The present study investigated the long-term effects of calcaneal fractures on the plantar pressure distribution during human gait. Fourteen patients partcipated in a follow-up study and were assigned to a group with good or poor calcaneus restoration as indicated by normal or reduced Böhlerʹs angle. Ten normal subjects with similar anthropometric characteristics were used for comparison. Gait analysis was performed by means of a capacitive pressure distribution platform. A comparison of the injured with the healthy foot of all patients revealed a statistically significant peak pressure decrease under medial areas of the foot (first metatarsal −24%) and an increase in lateral areas (midfoot +135%, fifth metatarsal +122%). This load shift towards a lateral loading indicates a persisting deviation of the gait pattern long after healing. Furthermore we investigated whether the success of the restoration of hindfoot geometry as reflected in Böhlerʹs angle had an effect on the foot loading characteristics. Therefore we compared the gait patterns of the two patient groups with the normal subjects. However, the results did not reveal more abnormal pressure patterns in the poorly reduced group.